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Malignant Melanoma of the External Auditory Canal

Milbrath, Mary M., M.D.; Campbell, Bruce H., M.D.; Madiedo, Gonzalo, M.D., Ph.D.; Janjan, Nora A., M.D.

American Journal of Clinical Oncology: February 1998 - Volume 21 - Issue 1 - p 28-30

Malignant melanoma of the ear, other than the pinna, rarely occurs. This is the first report of a melanoma confined to the external auditory canal. The case presented is of a 75-year-old man with a malignant melanoma confined to the external auditory canal. Excision of the tumor and surrounding lymphatics was accomplished with a lateral temporal bone resection, superficial parotidectomy, and selective neck dissection. The patient initially refused postoperative radiation therapy. Histologic evaluation documented a 17-mm thick malignant melanoma. All margins were clear and none of the nodes was positive. Eight months later, he returned with local, regional, and distant recurrence. Despite attempts at salvage with external radiation, brachytherapy, and chemotherapy, he died 13 months postoperatively with widespread disease. Melanoma confined to the external auditory canal has not been previously reported. A 17-mm thick melanoma carries a dismal prognosis. Despite initial negative surgical margins and lack of regional metastases, this patient developed a rapid, widespread pattern of recurrence.

From the Departments of Otolaryngology and Human Communication (M.M.M., B.H.C.), Pathology (G.M.), The Medical College of Wisconsin, Milwaukee, Wisconsin; and the Department of Radiation Oncology (N.A.J.), The University of Texas M.D. Anderson Cancer Center, Houston, Texas.

Address correspondence and reprint requests to Dr. Nora A. Janjan, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Box 97, Houston, TX 77030.

© Lippincott-Raven Publishers.