A healthy 16-year-old girl presented with a 2-year history of a slowly enlarging mass in the left middle ear. She had no subjective complaints of hearing loss, otorrhea, tinnitus, or vertigo. She did report some intermittent brief periods of otalgia that lasted for seconds approximately 2 weeks before presentation. She denied having frequent otitis media as a child. Her medical history was significant for 1 episode of nephritis at the age of 1 year that had been confirmed by renal biopsy. She had no family history of hearing loss.