||Any unusual or uncharacteristic growths arising in the external canal should be biopsied.
All tissue removed from the external auditory canal should be submitted for histopathological sectioning, staining and microscopy.
Occasionally, a squamous cell carcinoma is discovered unexpectedly after sending an apparently benign inflammatory polyp for routine histopathology.
If pain or bleeding develops in cases of chronic otitis externa or chronic suppurative otitis media, a careful inspection of the ear must be carried out to exclude the possibility of an underlying neoplasm.
A computerized tomographic scan is useful in determining the extent and spread of malignant lesions in this area.
These cases should be referred promptly to a specialist for management.
Other Malignant Disorders
Melanomata and malignant growths arising from the glands of the external ear canal (ceruminoma, adenocarcinoma) may also occur. It is important to differentiate malignant canal disease primarily involving the external auditory canal from that which encroaches upon it, as for example carcinoma of the middle ear, parotid tumours, or rodent ulcer of the pinna.
This apparently innocent soft tissue lesion arising from the posterosuperior wall of the cartilaginous external canal was excised solely on the basis of the clinician's inability to diagnose the lesion otoscopically. Pathological examination revealed the lesion to be a primary adenocarcinoma of the external canal.