Cavernous Hemangioma of the External Auditory Canal in Patients Older than 60 Years: A Rare Tumor

Clinical Approaches To External Auditory Canal Hemangiomas: A Systematic Review

OBJECTIVES

Hemangioma is a common soft tissue tumor that can be categorized mainly into cavernous, capillary, and venous subtypes. It usually develops in the head and neck and rarely in the external auditory canal (EAC).

METHODS

A systematic review of patients with capillary hemangioma of the EAC was performed. A computerized systematic search was conducted in PubMed, Scopus, and Web of Science to extract relevant studies for a qualitative review.

RESULTS

A total of 38 patients were included in the systematic review, and half of them were men. Hearing loss was the most common presenting feature (n = 19; 50%), followed by aural fullness (n = 15; 39.4%). Cavernous hemangioma was the predominant type (n = 22, 57.8%). Endaural and transcanal surgical approaches were the most frequent, with ten (26.3%) and nine (23.6%) cases, respectively. Most of the patients (n = 31; 81.5%) had no recurrence.

CONCLUSIONS

Hemangioma of the EAC may not be uncommon as healthcare professionals may expect. Hearing loss, aural fullness, and tinnitus are possible symptoms, but many patients remain asymptomatic. Surgical excision is the main effective management option, and complete resolution is the most prevalent outcome. Computed tomography assists in the diagnosis, but histopathological examination after resection is mandatory for the definitive diagnosis.

Capillary Hemangioma Involving the External Auditory Canal: Case Report and Review of the Literature

Hemangioma is a frequently observed soft tissue tumor that can be classified into cavernous, capillary, and venous subtypes. It occurs frequently in the head and neck; however, with rare reports of hemangiomas in the external auditory canal (EAC). The present study describes the case of a 57-year-old male patient who presented to our center with a subsequent diagnosis of capillary hemangioma of the EAC. The entire lesion was surgically removed, with no evidence of recurrence on the subsequent follow-up.

OUP accepted manuscript

Cavernous hemangioma of the external auditory canal (EAC) is a rare clinical finding. Endoscopic ear surgery has been successfully applied for various ear pathologies with a wider surgical sight, minimal canal cuts and precise manipulation of soft tissues. We report a case of a 60-year-old woman with hemangioma of EAC which increased in size without treatment for several years. She underwent excision of the hemangioma using transcanal endoscopic approach. The endoscopic transcanal approach allowed surgical resection of EAC cavernous hemangioma with wider views and minimally invasive techniques.

Arteriovenous Malformation in the Auricle in a 59-Year-Old Woman

Arteriovenous malformation (AVM) is a vascular lesion with a direct communication between an artery and a vein without a capillary system. AVM primarily occurs in the intracranial area, but can also occur in the extracranial area. If there is a tender mass with pulsation or recurrent bleeding in the auricle, AVM should be considered even though it rarely occurs in the auricle. AVM in the ear should be managed carefully because the skin is thin in the ear, the cartilage could be involved, and progressive growth or inappropriate management could cause bleeding, infection, and cosmetic problems such as deformity. I present a case of a 59-year-old woman with AVM in the auricle.

Capillary hemangioma in the external auditory canal

Hemangioma is a benign vascular soft tissue tumor. It is the most common soft tissue tumor in children and >60% of hemangiomas occur in the head and neck region. However, these tumors are rare in the external auditory canal (EAC). This case report describes a case of capillary hemangioma in the EAC in a woman 54 years of age. With the patient under local anesthesia in microscopic surgery, the mass was excised completely via a transcanal approach. If there is a cystic and pinkish mass in the EAC with symptoms of bleeding or pulsatile tinnitus, hemangioma should be considered. For symptomatic hemangioma, complete surgical excision is necessary and the prognosis is good after excision. Histopathologic confirmation is mandatory after excision.