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Clinical Problem Solving
June 2014

Dark Brownish Cutaneous Mass in the Cavum Concha

Author Affiliations
  • 1Jeju National University School of Medicine, Jeju, South Korea
  • 2Yonsei University College of Medicine, Seoul, South Korea
JAMA Otolaryngol Head Neck Surg. 2014;140(6):571-572. doi:10.1001/jamaoto.2014.565

A woman in her 60s presented with 1-year history of a slow-growing mass in the cavum concha of the right ear. She reported having no pain, itching sense, or bleeding tendency. She did not have any clinically significant medical or family history, and she denied the previous surgery around the right ear. The physical examination showed the well-demarcated and dark brownish cutaneous lesion in the cavum concha (Figure, A). There were no abnormal pigmented skin lesions on the rest of body, including the face, trunk, and extremities. There were no palpable enlargements of cervical, occipital, and submandibular lymph nodes. Excisional biopsy was performed. The histologic examination showed marked keratosis and thickened epidermis (blue arrowhead), the proliferation of basaloid cells (black arrowheads), keratin-filled pseudohorn cysts (black asterisk), and true horn cyst toward the surface (blue asterisk). Some scattered pigmented macrophages were observed in the epidermal layer and scaled epithelium (Figure, B).

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