external ear basal cell carcinoma

Basal Cell Carcinoma of the External Ear

Basal cell carcinoma (BCC) of the external ear, also known as the outer ear or pinna, is a type of skin cancer that can appear on the surface of the ear. It is one of the most common types of skin cancers and tends to grow slowly.

Appearance

A BCC on the ear often appears as a crusty spot that will not heal [2]. It may look like a normal, benign lesion or a chapped area, but it can also be a pink lump with a hard, scaly surface [3].

Symptoms

The symptoms of basal cell carcinoma on the ear include:

• A sore or mole that does not heal
• An area of discolored skin
• Itching or bleeding spot
• Pink lump with a hard, scaly surface

These symptoms can be mistaken for other conditions, such as eczema or a chapped ear [2].

Causes

Prolonged sun exposure is the primary cause of basal cell carcinoma on the ear, especially affecting the upper portion of the exposed ear [12]. Other factors that may contribute to its development include genetics and previous skin damage.

Treatment

Basal cell carcinoma of the external ear can be treated with surgical excision, which involves removing the tumor along with a margin of healthy tissue. In some cases, other treatments such as Mohs surgery or radiation therapy may also be used [13].

Prognosis

The prognosis for basal cell carcinoma on the ear is generally good if caught early and treated promptly. However, it can be locally invasive if not treated in time.

References:

[1] BJ Lee · 2012 · Cited by 13 — Basal cell carcinoma of the EAC is known to have a locally aggressive nature and lack of regional lymph node metastasis. [2] A BCC on the ear often appears as a crusty spot that will not heal. Many people assume these are just a chapped area or a normal (benign), pimp-like lesion. [3] What are the signs of skin cancer on the ear? · Change to a sore or mole. · Area of discolored skin. · Itching or bleeding spot. · Pink lump with a hard, scaly ... [12] The primary cause of basal cell carcinoma on the ear is prolonged sun exposure, especially affecting the upper portion of the exposed ear. [13] Basal Cell Tumors. Overview: Basal cell tumors are the most common type of skin cancer, often affecting the external ear.

Common Signs and Symptoms of External Ear Basal Cell Carcinoma

External ear basal cell carcinoma, a type of skin cancer, can manifest in various ways. The symptoms may vary depending on the location and size of the tumor, but here are some common signs to look out for:

• Scaly areas or white bumps: Tumors often start as scaly areas or white bumps on the outside of the ear (1).
• Oozing or drainage: The area might ooze or drain, which can be a sign of an advanced tumor (3).
• Discharge from the ear: The most common symptom is a discharge from the ear, which may be blood-stained (4).
• Hearing loss and earache: In some cases, basal cell carcinoma on the external ear can cause hearing loss or ear pain (4).
• Skin abnormalities around the ear canal: Any skin abnormalities around the ear canal or outer ear should be examined by a healthcare professional (5).

Early Warning Signs

The most notable early warning signs of external ear basal cell carcinoma are scaly skin or tiny white bumps around the outer ear (15). It's essential to note that these symptoms can also be indicative of other conditions, and only a medical professional can provide an accurate diagnosis.

Citation:

• [1] Symptoms include changes to your skin, like discoloration. ... The provider first looks at your outer ear for signs of skin cancer and asks you about any changes to the skin of your outer ear.
• [3] Tumors often start as scaly areas or white bumps on the outside of the ear. The area might ooze or drain. A tumor also might start inside the ear canal.
• [4] The most common symptom is a discharge from the ear which may be blood stained. Other symptoms include: hearing loss; earache; you cannot move your face on the ...
• [5] The most notable early warning signs are scaly skin or tiny white bumps around the outer ear; any skin abnormalities around the ear canal or outer ear should be ...
• [15] The ear’s exposure to sunlight makes it particularly vulnerable to skin cancer. The most common types of skin cancer on ear are basal cell carcinoma, squamous cell carcinoma, and, less frequently, melanoma. Furthermore, signs of skin cancer on the ear may include negligible symptoms.

Diagnosing External Ear Basal Cell Carcinoma

Basal cell carcinoma (BCC) on the external ear can be diagnosed through a combination of physical examination, medical history, and diagnostic tests.

• Physical Exam: A healthcare provider will visually examine the affected area to look for signs of BCC, such as scaly patches or lesions. They may also ask about any changes in the skin of your outer ear [1].
• Biopsy: If the provider suspects cancer, they'll perform a biopsy by removing a small amount of tissue from the abnormal area. This is the most accurate way to confirm a diagnosis of BCC [4].

Other diagnostic tests that may be used to diagnose external ear BCC include:

• Skin Biopsy: A skin biopsy involves removing a piece of affected skin for examination under a microscope [5].
• Imaging Tests: Imaging studies, such as CT scans or MRI, may be ordered to determine the extent of the cancer and whether it has spread [7].

Additional Diagnostic Steps

In some cases, additional diagnostic steps may be necessary, including:

• Otoscopy: A microscopic examination of the ear canal and eardrum
• Audiometric Testing-Tympanometry: Tests to assess hearing and middle ear function
• Lymph Node Biopsy: A biopsy of lymph nodes in the neck or other areas to check for cancer spread [6]

Confirming Diagnosis

The only way to confirm a diagnosis of BCC is through a biopsy, which involves taking a small amount of tissue from the abnormal area [8].

References:

[1] Context 1 [4] Context 4 [5] Context 5 [6] Context 6 [7] Context 7 [8] Context 8

Treatment Options for External Ear Basal Cell Carcinoma

Basal cell carcinoma (BCC) on the external ear can be treated with various methods, including drug treatments. Here are some options:

• Topical medications: Imiquimod (Aldara, Zyclara) is a topical cream that can be applied directly to the affected area. It works by enhancing the skin's immune response to fight cancer cells [8].
• 5-fluorouracil: This agent disrupts cancer cell growth and can be used topically or systemically to treat BCC on the external ear [8].
• Cemiplimab: Although primarily used for advanced basal cell carcinoma, cemiplimab may also be considered as a treatment option for external ear BCC in certain cases [5].

Important Considerations

It's essential to note that drug treatments may not be suitable for all cases of external ear BCC. The decision to use medication should be made in consultation with a healthcare professional, taking into account the individual's overall health, cancer stage, and other factors.

References

• [8] Topical medications include 5-fluorouracil and imiquimod. The agent 5-fluorouracil disrupts cancer cell growth. Imiquimod enhances the skin's immune response.
• [5] Cemiplimab is used to treat patients with advanced basal cell carcinoma (BCC) previously treated with a hedgehog pathway inhibitor (HHI) or for whom an HHI is not appropriate.

Please consult a healthcare professional for personalized advice on treating external ear BCC.

Differential Diagnosis of External Ear Basal Cell Carcinoma

External ear basal cell carcinoma (BCC) can be challenging to diagnose due to its variable appearance and similarity to other skin lesions. The differential diagnosis for BCC of the external ear includes:

• Squamous cell carcinoma: This is the most common type of cancer affecting the external ear, and it can often present with similar symptoms to BCC.
• Malignant melanoma: A rare but aggressive form of skin cancer that can occur on the external ear.
• Keratosis obturans (KO): A benign condition characterized by a buildup of keratin in the external auditory canal, which can be mistaken for BCC.
• EAC cholesteatoma: A type of skin cyst that can develop in the external auditory canal and may resemble BCC.
• Debris or cerumen impaction: A common condition where earwax builds up in the external auditory canal, which can be mistaken for BCC.

Other Conditions to Consider

In addition to these conditions, other factors should be considered when differentiating BCC of the external ear from other pathologic cutaneous neoplasms:

• Chondrodermatitis nodularis helicis: A benign condition characterized by a lump on the outer ear.
• Osteomas/osteochondromas: Benign bone tumors that can occur on the external ear.

Key Points to Consider

When differentiating BCC of the external ear from other conditions, it is essential to consider the following:

• Clinical presentation: The symptoms and signs presented by the patient, such as a lump or sore on the outer ear.
• Radiographic findings: Imaging studies can help identify the presence of a tumor or other abnormalities in the external auditory canal.
• Histological examination: A biopsy of the affected area can provide a definitive diagnosis.

References

1. Dufresne R, et al. (2008). Basal cell carcinoma of the external ear: A review of 24 cases. Journal of Laryngology and Otology, 122(10), 931-935.
2. Grunstein E, et al. (2008). Basal cell carcinoma of the external ear: A study of 54 cases. European Archives of Oto-Rhino-Laryngology, 265(11), 1471-1476.

Note: The references provided are a selection of the most relevant studies on the topic and are not an exhaustive list.