Skip to main content

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

Abstract

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.

References

  1. 1

    Ghosh A, Saha SN, Saha VP, Sadhu A, Chattopadyay S. Infratemporal fossa of myoepithelial carcinoma — a rare case report. Oral Maxillofac Surg 2009; 13: 59–62.

    Article  Google Scholar 

  2. 2

    Tran TL, Broholm H, Daugaard S, Fugleholm K, Poulsgaard L, Prause JU, et al. Myoepithelial carcinoma of the orbit: a clinicopathological and histopathological study. APMIS 2010; 118: 324–330.

    Article  Google Scholar 

  3. 3

    Kong SK, Goh EK, Chon KM, Lee IW. Epithelial-myoepithelial carcinoma in the external auditory canal. Otolaryngol Head Neck Surg 2008; 139: 598–599.

    Article  Google Scholar 

  4. 4

    Joseph LD, Ravikumar A, Kanan S, Prathiba D. Malignant myoepithelioma of the mastoid region: A case report. Indian J Otlaryngol Head Neck Surg 2007; 59: 194–196.

    Article  Google Scholar 

  5. 5

    W Cheuk, JKC Chan. Christopher D, M Fletcher, editors. Salivary gland tumours, chapter 7. Diagnostic histopathology of tumours. 3rd ed. USA: Elsevier Health Sciences; Vol. 1:2007. 260–262.

    Google Scholar 

  6. 6

    Chen KT. Myoepithelioma of the external auditory canal. J Laryngol Otol 1982; 96: 955–958.

    Article  CAS  Google Scholar 

  7. 7

    Lau DP, Goddard MJ, Bottrill ID, Moffat DA. Epithelial-myoepithelial carcinoma of the parotid gland. An unusual cause of ear canal stenosis. J Laryngol Otol 1996; 110: 493–495.

    Article  CAS  Google Scholar 

  8. 8

    Dirier A, Guzel A, Karadayi B, Ozekinci SO, Tatli M. Malignant myoepithelioma of the external auditory canal: a case report. Int J Clin Pract 2009; 63: 336–337.

    Article  CAS  Google Scholar 

  9. 9

    Hagisawa M, Yamasoba T, Ohashi K, Ishida T. A case of middle-ear myoepithelioma. Otolaryngol Head Neck Surg 2006; 135: 967–968.

    Article  Google Scholar 

  10. 10

    Hornick JL, Fletcher CD. Myoepithelial tumors of soft tissue: a clinicopathologic and immunohistochemical study of 101 cases with evaluation of prognostic parameters. Am J Surg Pathol 2003; 27:1183–1196.

    Article  Google Scholar 

  11. 11

    Nagao T, Sugano I, Ishida Y, Tajima Y, Matsuzaki O, Konno A, et al. Salivary gland malignant myoepithelioma: a clinicopathologic and immunohistochemical study of ten cases. Cancer 1998; 83:1292–1299.

    Article  CAS  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Sudipta Pal MS.

Additional information

Conflicts of interest

There are no conflicts of interest.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Saha, V.P., Pal, S., Saha, S. et al. Myoepithelial carcinoma of the ear: A rare case report and review of the literature. Egypt J Otolaryngol 30, 171–175 (2014). https://doi.org/10.4103/1012-5574.133223

Download citation

Keywords

  • immunohistochemistry
  • lateral temporal bone resection
  • myoepithelial carcinoma
  • scalp flap
  • tympanomastoid mass