Sahoo Anjan Kumar, Chakraborty Namrata, Bonthu Pavan Kumar
Department of ENT and Head Neck Surgey, All India Institute oF Medical Sciences, BhopalMadhya Pradesh, India.
Iran J Otorhinolaryngol. 2023 Mar;35(127):109-112. doi: 10.22038/IJORL.2023.67509.3307.
Seborrhoeic keratosis (SK) is a benign neoplasm of the skin. They are usually found to occur anywhere in the body except palms, soles and mucous membranes. The skin of the external auditory canal is an extremely rare site for the occurrence of this benign neoplasm. Malignant transformation rarely occurs in this benign condition. It should be differentiated from other malignant condition like squamous cell carcinoma, basal cell carcinoma, Bowen's disease, malignant melanoma or keratoacanthoma. Surgery is the mainstay of treatment though recurrence is very common. It can be removed by cryotherapy using liquid nitrogen or curettage, light fulgaration, shave removal or painting with pure TCA if the lesion is small. Diathermy shoul be used as minimal as possible to avoid scar formation.
An elderly female presented to ENT OPD with left ear blood-stained discharge. On inspection there was irregular blackish mass filling the entire left external auditory canal, fine needle aspiration cytology came to be seborrhoeic keratosis. Since on imaging the tumor was confined to the external auditory canal, it was excised completely by transcanal route. Surprisingly histopathology came to be squamous cell carcinoma. Considering the age and limited confinement of the tumor, she was kept on regular follow up.
Seborrhoeic keratosis though a common benign tumor, malignant transformation may occur. Treatment is patient specific and may be modified considering the age and comorbidity of the patient.
脂溢性角化病(SK)是一种皮肤良性肿瘤。它们通常见于身体任何部位,除了手掌、脚底和黏膜。外耳道皮肤是这种良性肿瘤极其罕见的发病部位。这种良性病变很少发生恶变。它应与其他恶性疾病如鳞状细胞癌、基底细胞癌、鲍温病、恶性黑色素瘤或角化棘皮瘤相鉴别。手术是主要的治疗方法,不过复发很常见。如果病变较小,可以通过液氮冷冻疗法、刮除术、轻度电灼、削除术或用纯三氯乙酸涂抹来去除。应尽量少用电凝术以避免形成瘢痕。
一名老年女性因左耳血性分泌物就诊于耳鼻喉科门诊。检查发现整个左外耳道有不规则黑色肿物,细针穿刺细胞学检查结果为脂溢性角化病。由于影像学检查显示肿瘤局限于外耳道,遂通过经耳道途径将其完全切除。令人惊讶的是,组织病理学检查结果为鳞状细胞癌。考虑到患者年龄以及肿瘤局限的情况,对她进行定期随访。
脂溢性角化病虽是一种常见的良性肿瘤,但可能发生恶变。治疗应因人而异,并可根据患者的年龄和合并症进行调整。