Cavernous Hemangioma of the External Canal, Tympanic Membrane, and Middle Ear Cleft: A Case Report

Abstract

Cavernous hemangioma involving the external canal, tympanic membrane, and middle ear cavity is extremely rare. We present a case of a 45-year-old woman who had progressive right sided decreased hearing, pulsatile tinnitus, and aural fullness of 7 months duration. Microscopic examination, imaging studies, surgical treatment, and histological evaluation are reported. To the best of our knowledge, this is the first case of cavernous hemangioma with simultaneous involvement of the external ear, tympanic membrane, middle ear, and attic reported in English literature.

Keywords: Cavernous hemangioma; External ear; Middle ear; Vascular lesion.

Fig. 1

a Endoscopic view of right ear shows a red-colored, mass occupying the medial portion of the external canal and pushing posterior part of the tympanic membrane. b Endoscopic view of right ear after elevation of tympano-meatal flap shows the vascular mass resting over posterior wall of the external canal and filling the middle ear cavity

Fig. 2

a Computed tomography scan of temporal bone, coronal view shows right side soft tissue mass involving medial part of the external canal, tympanic membrane, middle ear, and reaching the attic (white arrow). b Magnetic resonance imaging T1 with gadolinium contrast (axial view) shows hyperintense lesion in the right ear (white arrow)

Fig. 3

Histopathologic examination of the specimen showed a cavernous hemangioma composed of dilated, thin walled vascular spaces of variable diameter filled with red blood cells, and lined by flat endothelial cells (H&E, ×200)