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External auditory canal paraganglioma: an atypical presentation

Published online by Cambridge University Press:  01 October 2012

N Grover*
Affiliation:
ENT Department, Royal National Throat, Nose and Ear Hospital, London, UK
F Amen
Affiliation:
ENT Department, Royal National Throat, Nose and Ear Hospital, London, UK
A Gallimore
Affiliation:
Department of Histopathology, University College London Hospital, London, UK
G Brookes
Affiliation:
ENT Department, Royal National Throat, Nose and Ear Hospital, London, UK
*
Address for correspondence: Ms Nancy Grover, Department of ENT, Whipps Cross Hospital, London E11 1NR, UK E-mail: [email protected]

Abstract

Objective:

We present the first published description of a painful paraganglioma of the external auditory canal. Atypical histopathology made the diagnosis difficult. We discuss the potential pitfalls of clinical diagnosis and treatment of such a case.

Clinical presentation:

A 49-year-old woman presented with left-sided otalgia, hearing loss and tinnitus. Physical examination revealed a firm swelling arising from the superior portion of the left external auditory canal. A clinical diagnosis of otitis externa was made.

Intervention:

There was minimal response to medical treatment. The swelling was aspirated, leading to brisk bleeding. A tumour was suspected from the computed tomography scan, and confirmed by a biopsy. The patient underwent excision of the paraganglioma. The histopathology was atypical, making diagnosis difficult.

Conclusion:

Such unusual masses of the external ear should always be borne in mind, especially when dealing with atypical presentations of commonly encountered diseases. Clinicians should have a low threshold for early intervention with imaging and biopsy.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 2012

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