A 75-year-old man presented with a 1-month history of a friable mass on the left antihelix that was associated with heavy, prolonged bleeding. Antibiotic therapy was unsuccessful. Physical examination revealed 2 soft, insensate masses measuring 1 cm and 2 cm, respectively, on the left antihelix (Figure 1). The external auditory canal and the tympanic membrane were normal. There was no cervical lymphadenopathy. The patient's cancer history included renal cell carcinoma, melanoma on the left shoulder, and squamous cell carcinoma of the scalp. His surgical history included a partial nephrectomy, an adrenalectomy, and wide local excisions of the previous skin cancers. His family history was noncontributory. His social history was remarkable for excessive smoking and sun exposure. A review of systems was noncontributory. Computed tomography and whole-body positron emission tomography (PET) demonstrated no other abnormalities.
Nikolaus T. Sneshkoff, Judy H. Freeman, Bryan J. Liming. Pathology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2010;136(7):745. doi:10.1001/archoto.2010.86-a