Solitary Trichoepithelioma of the External Auditory Canal: A Rare Cause of Ear Pain in a Pediatric Patient

Solitary Trichoepithelioma of the External Auditory Canal: A Rare Cause of Ear Pain in a Pediatric Patient

Authors

  • Lauren E. Melley, DO Department of Otolaryngology -Head and Neck Surgery, Philadelphia College of Osteop -athic Medicine, 4190 City Line Avenue, Philadelphia, PA, USA 19131 https://orcid.org/0000-0003-2673-8129
  • Eli Bress, DO Department of Otolaryngology -Head and Neck Surgery, Philadelphia College of Osteop -athic Medicine, 4190 City Line Avenue, Philadelphia, PA, USA 19131 https://orcid.org/0000-0001-5276-6524
  • Megan Saltsgaver University of Illinois College of Medicine at Rockford, 1601 Parkview Ave, Rockford, IL 61107 https://orcid.org/0009-0000-8581-5281
  • Judy Pascasio, MD Department of Pathology and Laboratory Medicine, St. Christopher's Hospital for Children, Philadelphia, PA, USA
  • Alexander Manteghi, DO Division of Pediatric Otolaryngology, St. Christopher’s Hospi -tal for Children, Philadelphia, PA, USA https://orcid.org/0000-0001-9714-6687

Abstract

Trichoepitheliomas are benign hair follicle tumors that typically present as slow-growing sharply circumscribed, symmetrical, domeshaped lesions. They can occur as a solitary lesion or as part of the autosomal dominant multiple familial form. Trichoepitheliomas are predominantly confined to the face with a symmetrical distribution along the nose, cheeks, eyelids, forehead, and preauricular area. Wepresent the first pediatric case of a solitary trichoepithelioma in the external ear canal of 12-month-old girl presenting to the ENT office
with otalgia and an EAC mass noticed by the patient's Mom 10 daysprior. The patient underwent complete excision of a 1.5 cm cyst-likestructure without rupture and an acellular graft was used to cover the defect. Histologic evaluation demonstrated numerous hair follicles, each surrounded by a well-defined perifollicular sheath consistent with a trichoepithelioma. Both clinically and histologically, trichoep -itheliomas are similar to basal cell carcinoma and have a low risk of malignant transformation. Excisional biopsy with complete resection of overlying skin is recommended and should be performed promptly to avoid delay in diagnosis.

References

Rallan D, Harland CC. Brooke-Spiegler syndrome: treatment with laser ablation. Clin Exp Dermatol 2005; 30: 355–7.

Simpson W, Garner A, Collin JR. Benign hairfollicle derived tumours in the differential diagnosis of basal-cell carcinoma of the eyelids: a clinicopathological comparison. Br J Ophthalmol 1989; 73:347-53.

Hong JY, Seok J, Kim JM, Jang YJ, Kim BJ. Successful treatment of trichoepithelioma with a novel insulated, monopolar, radiofrequency microneedle device. Clin Exp Dermatol.2017;43(1):108-109. doi:10.1111/ced.13218.

Bettencourt MS, Prieto VG, Shea CR. Trichoepithelioma: a 19-year clinicopathologic re-evaluation. J Cutan Pathol.1999;26(8):398-404. doi:10.1111/j.1600-0560.1999.tb01864.x.

Greywal T, Rubin AG, Jiang B. A Rare Presentation of Basal Cell Carcinoma Arising within Trichoepithelioma: A Diagnostic Challenge. Cureus. 2019. doi:10.7759/cureus.5401.

Lee KH, Kim JE, Cho BK, Kim YC, Park CJ. Malignant transformation of multiple familial trichoepithelioma: case report and literature review. Acta Derm Venereol. 2008;88:43-6.

Pincus LB, McCalmont TH, Neuhaus IM, Kasper R, Oh DH. Basal cell carcinomas arising within multiple trichoepitheliomas. J Cutan Pathol. 2008;35:59-64.

Mapar MA, Ranjbari N, Afshar N, KarimzadehI, Karimzadeh A. Severely disfiguring multiple familial trichoepitheliomas with basal cell carcinoma. Indian J Dermatol Venereol Leprol. 2014;80:349-52.

James WD, Berger T, Elston D. Andrew’s diseases of the skin: clinical dermatology. Elsevier Health Sciences; 2011.

Bibi CO, Fliss DM, Avinoach I, Brenner H,Tovi F. Multiple trichoepithelioma occluding both external auditory canals. Head & Neck.1990;12(3):257-260. doi:10.1002/hed.2880120312.

Magliulo G, Appiani MC, Cerbelli B, Re M. Solitary Nonfamilial Desmoplastic Trichoepithelioma of the External Auditory Canal. Otol Neurotol. 2012;33(8). doi:10.1097/mao.0b013e31825d6468.

Downloads

Published

2022-12-01

How to Cite

1.
Solitary Trichoepithelioma of the External Auditory Canal: A Rare Cause of Ear Pain in a Pediatric Patient. Journal of Otolaryngology and Rhinology Research [Internet]. 2022 Dec. 1 [cited 2024 Sep. 19];3(04):114-7. Available from: http://jorr.info/index.php/jorr/article/view/54