Giant Pyogenic Granuloma of the External Auditory Canal: A Rare Case Report

Pyogenic granuloma is a benign vascular tumor that usually occurs following trauma, irritation, in a background of immunosuppression or other unknown mechanisms leading to angiogenesis and vasculogenesis. The treatment of choice is surgical with en bloc resection followed by a watch and see approach since pyogenic granuloma would not exhibit any malignant transformation. We report a rare case of a giant pyogenic granuloma located in the external auditory canal, causing severe otalgia resistant to analgesic treatment, progressive hearing loss, insomnia, and purulent otorrhea. The large mass was initially embolized by using Embosphere and then partially resected using an endaural approach under the microscope. The remaining part of the mass required a retroauricular approach to achieve total excision. No recurrence was observed 4 months after resection. The radiological evaluation alone can be insufficient to make a preoperative diagnosis, which is often based on histopathologic findings. After excision of pyogenic granuloma, observation with regular follow-up is advised since these lesions have no malignant potential.