A case of adenoid cystic carcinoma of the external ear canal

Nario Kazuhiko, Yamanaka Toshiaki, Hosoi Hiroshi

doi:10.5106/jjshns.21.203

We report a rare case of an adenoid cystic carcinoma (ACC) of the external ear canal. A 49-year-old man complained of having left ear pain for about one year and had been treated for otitis externa at another hospital before being referred to our hospital for further examination and treatment. The lesion only showed erosion of the skin over the cartilaginous portion of the ear canal. A biopsy of the lesion demonstrated ACC of the external ear canal. This case was classified as T1 according to the Pittsburgh staging system. The patient was treated surgically by partial removal of the external ear canal including a partial parotidectomy followed by radiotherapy (intensity modulated radiotherapy: IMRT). For histological studies, the lesion was considered grade II, in accordance with the classification proposed by Szanto. The Ki-67 labeling index, which provides objective information that determines a malignant potential, was 12.7%.<br>We also reviewed 47 cases diagnosed as ACC of the external ear canal that were reported in Japan between 2000 and 2010. The majority of these patients complained of ear pain. According to the Kaplan-Meier method, the survival rate in this group would be 89.1% after 5 years and 58.4% after 10 years. 15 of the 47 (29.7%) cases developed local recurrences or pulmonary metastases. ACC of the external ear canal shows poor long-term survival rates. A wide surgical resection is required to cure ACC arising in the ear canal. Patients who have been treated for ACC involving the external ear canal should be followed-up for many years thereafter.

A case of adenoid cystic carcinoma of the external ear canal

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