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A 19-year-old white man presented with a 1-year history of painful, bleeding lesions in his left external auditory canal (EAC). Physical examination showed multiple exophytic, pedunculated, irregular masses located on the posterolateral aspect of the left EAC (Figure 1). Both tympanic membranes were normal, with appropriate movement on insufflation. The patient received multiple treatments, including otic solution drops (Corticosporin) and silver nitrate applications, without improvement. His medical history was remarkable for congenital hypothyroidism and a bicuspid aortic valve, with stenosis and regurgitation, as well as for nonbleeding internal hemorrhoids. His surgical history was notable for removal of a facial hemangioma. His family history, social history, and a review of symptoms were noncontributory.
Wirtz E, Senchak A, Belnap C, Ramsey M. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2008;134(2):215. doi:10.1001/archoto.2007.29-a