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Clinical Problem Solving: Pathology
January 2006

Pathology Quiz Case

Author Affiliations

Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan

 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2006;132(1):109. doi:10.1001/archotol.132.1.109

A 48-year-old woman presented with a 2-month history of progressive hearing loss in her right ear, accompanied by intermittent purulent and blood-tinged otorrhea. Her medical history was remarkable for type 2 diabetes mellitus and for an operation that had been performed on the lower part of her left leg because of a bone tumor 3 three years earlier. Otoscopy of her right ear showed a lobulated, purple mass occluding the entire external auditory canal. The findings of her neurologic and head and neck examinations were otherwise within normal limits. A computed tomographic scan of the temporal bone demonstrated an approximately 24-mm soft tissue mass, with obliteration of the deep portion of the right external auditory canal and partial erosion of the anterior bony canal (Figure 1). Magnetic resonance imaging of the skull base revealed homogeneous enhancement of the tumor, with focal bony erosion over the tympanic plate of the condylar fossa.

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