external ear squamous cell carcinoma

External Ear Squamous Cell Carcinoma: A Rare but Aggressive Malignancy

Squamous cell carcinoma (SCC) of the external ear is a rare and aggressive type of cancer that affects the outer ear. It is one of the most common malignancies to occur in the external auditory canal, accounting for about 80% of tumors within the temporal bone [15].

Causes and Risk Factors

The exact cause of SCC of the external ear is unknown, but it is believed to be related to chronic sun exposure, long-term ear infections or chronic irritation, and potentially linked to radiation exposure [9]. Individuals with a history of skin cancer in other areas are also at higher risk.

Symptoms

The main symptom of SCC of the external ear is a spot or sore on the ear flap that doesn't heal within 4 weeks. Most cases present as pink lumps with a hard scaly surface [6]. Other symptoms may include changes to the skin, such as discoloration, and rough, scaly patches or sores.

Staging and Prognosis

The staging of SCC of the external ear is complex and requires consideration of clinical factors. Poor prognostic factors include tumors larger than 2 cm in size, depth greater than 4 mm, poorly differentiated tumors, perineural invasion, development within a scar, previously treated squamous cell carcinoma at the site, immunosuppression, and location within the inner portion of the canal with deep involvement of the temporal bone [10].

Treatment

Prompt treatment is essential for SCC of the external ear. The most effective treatment options include surgery, radiation therapy, and chemotherapy.

References:

[1] - Squamous cell carcinoma of the external auditory canal and middle ear are rare malignancies... (Search result 1) [6] - Symptoms include changes to your skin, like discoloration. Most cases of ear skin cancer are easily treated... (Search result 2) [9] - The most common type is squamous cell carcinoma. The second most common type of skin cancer in the ear is basal cell carcinoma... (Search result 3) [10] - Poor prognostic factors: > 2 cm, depth > 4 mm, poorly differentiated tumors, perineural invasion... (Search result 10) [15] - The most common histologic type of EAC malignancies is squamous cell carcinoma (SCC)... (Search result 15)

Common Signs and Symptoms of External Ear Squamous Cell Carcinoma

External ear squamous cell carcinoma, a type of skin cancer, can manifest in various ways. The following are some common signs and symptoms to look out for:

• Rough, reddish scaly area: A rough, red patch on the outer ear skin is one of the most common visible signs of squamous cell carcinoma (1).
• Open sore (often with a raised border): An open sore or ulceration on the outer ear skin can be another indication of this type of cancer (11).
• Brown spot that looks like an age spot: A brown spot on the outer ear skin, which may resemble an age spot, can also be a sign of squamous cell carcinoma (11).
• **Firm, red nodules and sores with a scaly crust

Diagnostic Tests for External Ear Squamous Cell Carcinoma

External ear squamous cell carcinoma (SCC) can be challenging to diagnose due to its location and symptoms that may mimic other conditions. However, several diagnostic tests can help confirm the presence of this type of cancer.

• Otoscopy: A microscopic examination of the external auditory canal and eardrum is often performed to visualize any abnormalities or tumors.
• Audiometric testing-tympanometry: This test assesses the function of the middle ear and eardrum, which can be affected by SCC. It involves measuring the movement of the eardrum and the reflexes of the middle ear muscles.
• Imaging studies: Computed tomography (CT) scans or magnetic resonance imaging (MRI) may be ordered to visualize the tumor's size, location, and extent of spread. These tests can also help identify any involvement of surrounding structures, such as the temporal bone or facial nerve.
• Biopsy-histological examination: A biopsy is the only definitive way to confirm a diagnosis of SCC. A small tissue sample is taken from the affected area under local anesthesia, and then examined microscopically for cancer cells.

Additional Diagnostic Tests

Other diagnostic tests may be performed in some cases, including:

• Endoscopy: This test involves using a flexible tube with a camera to visualize the external auditory canal and eardrum.
• Lymph node biopsy: If lymph nodes are suspected to be involved, a biopsy may be performed to confirm the presence of cancer cells.

References

[6] The steps that should be followed to establish the diagnosis are the following: otoscopy, audiometric testing-tympanometry, imaging, and biopsy-histological examination. [9] [10] One common test used to diagnose ear tumors is imaging scans, such as computed tomography. [11] Imaging studies can help identify any involvement of surrounding structures, such as the temporal bone or facial nerve.

Note: The above information is based on the search results provided and may not be an exhaustive list of diagnostic tests for external ear squamous cell carcinoma.

Treatment Options for External Ear Squamous Cell Carcinoma

External ear squamous cell carcinoma (EAC) is a rare type of cancer that affects the outer ear. While surgery and radiotherapy are common treatments, drug treatment options are also available.

• Chemotherapy: Chemotherapy may be recommended for advanced disease, residual disease, or metastasis [6]. Several anticancer drugs, such as cisplatin, carboplatin, fluorouracil, docetaxel, and mitomycin, have been used to treat EAC [8].
• Immunotherapy: Immunotherapy has emerged as a first-line treatment for many cases of ear canal cancer, including EAC [4]. This approach uses the body's immune system to fight cancer.
• Combination therapy: A combination of chemotherapy and radiotherapy may be used in some cases, especially when surgery is not feasible or has been unsuccessful [7].

Key Points

• Chemotherapy is usually recommended for advanced disease, residual disease, or metastasis.
• Immunotherapy is now used as a first-line treatment for many cases of ear canal cancer, including EAC.
• Combination therapy may be used in some cases.

References

[4] - We now use immunotherapy as the first-line treatment for many cases of ear canal cancer. If the tumor responds to immunotherapy, you may not need further treatment [4]. [6] - Chemotherapy is usually recommended for advanced disease, residual disease, and metastasis [6]. [7] - The type of treatment for this tumor depends on the size, the type or stage of cancer, and the exact location of tumor. Surgery is usually performed first, but chemotherapy may be used in combination with radiotherapy [7]. [8] - Several anticancer drugs, such as cisplatin, carboplatin, fluorouracil, docetaxel, and mitomycin, are used to treat EAC [8].