Myoepithelial carcinoma of the ear: A rare case report and review of the literature

The aim of this study was to present a unique case report of myoepithelial carcinoma arising from the external auditory canal and presenting as a huge tympanomastoid mass along with a review of the literature. A 52-year-old woman presented with a large periauricular swelling of a 3-year duration with a recent increase in size over the last 3 months along with pain and bleeding from the mass. The patient was evaluated by clinical examination, haematological and biochemical tests, and computed tomographic and MRI scan of the tympanomastoid region. An incision biopsy was performed before definitive management was initiated. Computed tomographic scan and MRI were suggestive of a large tympanomastoid mass without any intracranial extension. The incisional biopsy report was suggestive of invasive adenocarcinoma. En-bloc excision of the mass including lateral temporal bone resection along with ipsilateral selective (levels I, II and III) neck dissection was performed under general anaesthesia. The resultant defect was reconstructed by a rotational scalp flap. Immunohistochemistry and histopathology of the excised specimen proved the diagnosis of myoepithelial carcinoma. After surgery, the patient was treated with adjuvant radiotherapy. At 1½ years of follow-up, the patient was doing fine, without any recurrence of disease. Myoepithelial carcinoma of the ear has rarely been reported in the literature. Histopathology along with immunohistochemistry is the mainstay of diagnosing of this unusual lesion. Meticulous planning and proper execution of optimum surgical excision is the primary treatment modality, which should be supplemented with radiation therapy. Long-term disease-free survival, although rare, can be achieved as in the present case report. © 2014, The Egyptian Oto - Rhino - Laryngological Society.