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Mass in the ear canal
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The diagnosis is adenoid cystic carcinoma (ACC) of the external auditory canal. It is commonly seen in the glandular tissues like salivary glands, breast, larynx, cervix, lacrimal glands, ear canal, etc. These tumours are slow growing but highly malignant. Microscopically four patterns are described: tubular, cribriform, basal, and solid varieties. Tubular and cribriform types have a better prognosis than basal and solid types.1
High resolution computed tomography of the temporal bone should be done in this case. It will reveal the extent of the tumour, including the integrity of osseous structures and intracranial invasion of the tumour.
ACC has a remarkable tendency for invasion of the perineural spaces, so it may present as facial nerve paralysis irrespective of the size. In view of recurrences after a long tumour-free period, unlike squamous cell carcinoma, survival rates of ACC should be assessed at 10, 15 and even 20 years, to be able
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