A 36-year-old human immunodeficiency virus–positive woman presented with complaints of hearing loss in her right ear, otorrhea, and a mass in her external auditory canal (EAC). She had been noncompliant with antiretroviral therapy. Physical examination revealed extensive polypoid tissue in the EAC and right-sided facial paresis (House-Brackmann grade III/VI). Audiological evaluation showed a right maximal conductive hearing loss. Findings on computed tomography of the temporal bone were consistent with chronic otomastoiditis. The patient underwent a right canal wall down tympanomastoidectomy and facial nerve decompression. Pathologic evaluation of the specimen demonstrated fibroconnective tissue with chronic inflammation and focal necrosis.
Tajudeen BA, Zeitler DM, Yee H, Roland JT, Roehm PC. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2010;136(1):101. doi:10.1001/archoto.2009.181-a