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Otorinolaringologia 2008 September;58(3):141-5


language: Italian

Primary adenoid-cystic carcinoma of the auditory external canal: a case report

Midulla R. 1, Federico B. 2, Cernigliaro G. 2, Piazza F. 2, Restivo S. 2, Paradiso Ciotti S. 1, Salvato M. 1, Maresi E. 1

1 Istituto di Anatomia Patologica, Policlinico “P. Giaccone” Università di Palermo, Palermo, Italia 2 Clinica Otorinolaringoiatrica Base Policlinico “P. Giaccone” Università di Palermo, Palermo, Italia


Primary adenoid-cystic carcinoma (ACC) of the external auditory canal (EAC) is an uncommon malignant epithelial tumour arising from the modified apocrine sudorific glands sited in the derma of the external ear. Symptoms are similar to those of other tumours arising in the auditory canal. Clinically, most patients complain ear pain, often of several years’duration and unresponsive to routine therapy, bleeding and discharge. On physical examination they show a nodular, sometimes ulcerated, mass stenosing the EAC. Wide surgical resection of the auditory canal followed by postoperative radiotherapy is usually the treatment of choice. We report a clinical case of a patient affected by primary ACC, who, at 36 months follow-up from surgery, doesn’t show signs of local or distant disease, and discuss the surgical, clinico-diagnostic, therapeutic and prognostic features. CT revealed neoformed tissue with reduction of the EAC calibre. Hhistology of a bioptic specimen tissue, showed the neoplastic cells proliferation with basophile cytoplasm, tubular and cribriform architecture. Such a finding led to the diagnosis of adenoid-cystic carcinoma and thus the tumour was subjected to surgical removal. Grossly the removed material showed a nodular, not capsulated neoformation, with infiltrative growth pattern measuring 1.5 cm in diameter. The immuno-histochemical techniques showed immunoreactivity for cytokeratin, epithelial membrane antigen (EMA), smooth muscle actin, and vimentin. While ACC is a rare neoplasm in this site, in presence of EAC tumefaction, it should be checked in the differential diagnosis with other tumour of the same area.

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