Simultaneous presentation of malignant external otitis and temporal bone cancer

Abstract

Malignant external otitis and squamous cell carcinoma of the external auditory meatus are both characteristically seen in the older population. While some of the signs and symptoms of these two diseases are similar (otalgia, otorrhea, bone destruction on computed tomographic scan), they have rarely been reported in the same patient. We present an unusual case of temporal bone cancer and malignant external otitis presenting concurrently in an elderly, nondiabetic host. Precipitating factors and diagnostic criteria are discussed. This case illustrates the importance of an adequate biopsy specimen in all patients presenting with presumed "classic" malignant external otitis. Consideration must also be given for the existence of malignant external otitis in the presence of carcinoma. Finally, evolution of malignant external otitis in this patient following aural irrigation supports previous suggestions that this disease may be induced iatrogenically.