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Malignant Transformation From Benign Papillomatosis of the External Auditory Canal

Objective Report a case of malignant transformation of benign ear canal papillomatosis to malignant squamous cell carcinoma (SCC) of the temporal bone. Patients A 73-year-old with papillomata involving the posterior and inferior walls of the right external auditory canal (EAC), which subsequently transformed into SCC. Interventions Radical mastoidectomy and excision of the tumor and then radical radiotherapy. Main Outcome Measures Loco-regional disease control. Recovery of facial nerve function. Results Approximately 20 months post-treatment, the patient remains disease free. No recovery of facial nerve function. Conclusion Malignant transformation of a benign EAC papilloma to SCC of the temporal bone has not been reported previously. The association of human papillomavirus with temporal bone SCC has been reported in small number of studies with human papillomavirus subtypes 16 and 18 isolated in a high proportion of cases. With the increased availability in genotyping, the question over whether there should be further genetic analysis of benign lesions to assess their susceptibility to malignant transformation has merit.