Tumors of external ear
Benign
lesions of external ear
1. Chondrodermatitis nodularis chronica helicis (CNCH):
Etiology
* unknown
* may
begins with some minor trauma to the ear that causes chronic inflammation of
the perichondrium, resulting in local vascular compromise. This vascular
disruption then creates the observed clinical sequelae of painful nodules.
Treatment
Surgical excision - surgical options include
curettage, electrocautery, carbon dioxide laser ablation, and excision of skin
and cartilage with closure
Medical options - radiation therapy,
cryotherapy and topical antibiotics.
2. Idiopathic cystic chondromalacia:
Lesions of ICC present as unilateral
asymptomatic swelling on the auricle and appear in the scaphoid fossa in 80% of
patients. The lesions contain viscous yellow fluid. Usually no ulceration
present.
Treatment
·
Intralesional
steroids
·
Simple
aspiration of the cyst fluid
·
Complete
excision of the cyst
·
Excising
the anterior cyst wall followed by sclerosing the posterior cyst wall with
1% iodine solution.
Premalignant lesions of external ear
1. Actinic keratosis (AK):
·
Cause:sun
exposure
·
AK
presents as round or irregularly shaped lesions that are scaly, keratotic, and
flat topped.
·
The
color varies from gray to deep brown.
·
Dysplastic
cells can be present.
Benign tumors of external ear
1. Osteoma-
The masses are solitary, unilateral,
and slow growing.
These are the most common bony
neoplasms of the temporal bone.
Osteomas are usually asymptomatic;
however, symptoms can arise if canal obstruction occurs.
2. Squamous papilloma:
Squamous papilloma may be a result of
exposure to the human papillomavirus. The lesion presents as a warty, elevated
lesion that may be pigmented.
3. Seborrheic keratosis:
It presents as an oval rough plaque.
Early, the lesion appears light yellow. Moreover, it becomes browner as its
size increases.
4. Sebaceous adenoma:
These tumours arise from sebaceous
glands located in the skin of the ear and EAC; they present as a smooth,
Elevated, Pedunculated, firm to-soft lesion.
The lesions usually are solitary and
smaller than 0.5 cm.
SA lesions can bleed from trauma. But
they rarely ulcerate.
5. Pilomatrixoma:
The lesion presents as a slow-
growing, bluish, solitary, and well-circumscribed nodule within the dermis of
the auricle.
6. Keratoacanthoma:
Keratoacanthoma has been linked to
sun exposure, chemical carcinogens, trauma, and possibly a viral etiology.
Keratoacanthoma arises from the hair follicles.
7. Ceruminoma:
The lesion is a result of neoplasia
of the ceruminous glands of the EAC
WHO classification:
·
Benign:
ceruminous adenoma and pleomorphic adenoma.
·
Malignant:
adenoid cystic carcinoma and adenocarcinoma
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