A Case of Squamous Papilloma of the External Auditory Canal and Tympanic Membrane Which Showed Temporary Regression Following Biopsy

Abstract

We present a rare case of squamous papilloma of the external auditory canal and tympanic membrane that disappeared temporarily after biopsy and then recurred several months later, with perforation of the tympanic membrane. A 67-year-old female patient with a 11-year history of left-sided ear blockage visited our hospital complaining of left-sided hearing loss and otorrhea. Otoscopic examination revealed a papillomatous lesion in the bony part of the left external auditory canal, with extension to the tympanic membrane. Histopathological examination of a biopsy specimen showed moderately acanthotic papillary squamous epithelium, without atypia. The papillomatous lesion disappeared 20 days post-biopsy. However, the papillomatous lesion recurred, and perforation of the left tympanic membrane was found 122 days later. The patient underwent successful canalplasty and myringoplasty. The final histopathological finding was squamous papilloma. There has since been no sequela or relapse until date, 2 years 9 months since the surgery.

It is possible that the biopsy of the squamous papilloma triggered an immune response that led to regression of the lesion in our immunocompetent patient. Clinical follow-up is considered necessary because any immune suppression may cause recurrence of the disease.