A 50-minute-old male infant N.Y. had dyspnea had a large mass in the pharynx. This tumor was covered with skin and was attached to the upper pole of the right palatine tonsil. It had a helix, antihelix, scapha, lobulus and a pit which resembled an external acoustic meatus. Microscopic examination showed a squamous cell epithelium, stoma consisting of connective and fibrous tissue with glands, hair follicles and cartilage.
The pathogenesis of this dermoid is unknown. It may represent the retention of a more primitive tissue of the auricle in the second internal cleft as early as three weeks in the embryonic stage. Both auricles were completely normal, so this dermoid may represent an included twin.
