Komune Noritaka, Kuga Ryosuke, Kida Yutaro, Manako Tomomi, Harada Rika, Masuda Shogo, Noda Teppei, Matsumoto Nozomu, Nakagawa Takashi
Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Otol Neurotol. 2025 Sep 1;46(8):972-977. doi: 10.1097/MAO.0000000000004559. Epub 2025 Jun 2.
Squamous cell carcinoma (SCC) of the external auditory canal has a favorable prognosis when complete resection with negative margins is achieved. Early diagnosis and timely referral to specialized centers are crucial. However, definitive diagnosis is often delayed due to challenges in timely referral and the need for multiple biopsies. This study aims to examine the diagnostic trajectory of SCC of the external auditory canal, focusing on the number of biopsies required and the process leading to definitive diagnosis.
Retrospective case review and descriptive study.
Tertiary referral center.
We conducted a retrospective case review at a tertiary referral center, analyzing 56 cases of SCC of the external auditory canal treated between January 2015 and February 2024.
Medical records were retrospectively reviewed.
The course of events leading up to their visit of our hospital, the number of biopsies performed to be diagnosed, and the histopathological findings.
The time from initial presentation to referral ranged from 1 to 785 days (mean: 170.6 d; median: 130 d). A definitive diagnosis was achieved with the first biopsy in 35 cases (62.5%), whereas 21 cases (37.5%) required multiple biopsies. Only 21.4% of the cases were definitively diagnosed at the initial presenting facility, whereas 32.1% were diagnosed at our hospital. More than 90% of the tumors were well-differentiated or well-to moderately/poorly differentiated SCC. The number of biopsies required to confirm a definitive diagnosis was significantly associated with longer delays in hospital referral (correlation coefficient: 0.3122, p = 0.0192). Two cases of the hyperkeratotic SCC were presented as representative cases in which a definitive diagnosis was challenging.
Early diagnosis of SCC of the external auditory canal relies on thorough biopsy evaluation. Given the tumor's tendency for high differentiation, obtaining biopsy samples with clear malignant features is critical for making an accurate and timely definitive diagnosis.
外耳道鳞状细胞癌（SCC）若能实现切缘阴性的完整切除，则预后良好。早期诊断并及时转诊至专业中心至关重要。然而，由于及时转诊存在挑战且需要多次活检，明确诊断往往会延迟。本研究旨在探讨外耳道SCC的诊断轨迹，重点关注所需活检次数以及最终确诊的过程。
回顾性病例分析及描述性研究。
三级转诊中心。
我们在一家三级转诊中心进行了回顾性病例分析，分析了2015年1月至2024年2月期间治疗的56例外耳道SCC病例。
对病历进行回顾性审查。
患者来我院就诊前的病程、确诊所需的活检次数以及组织病理学检查结果。
从首次出现症状到转诊的时间为1至785天（平均：170.6天；中位数：130天）。35例（62.5%）患者通过首次活检确诊，而21例（37.5%）患者需要多次活检。仅21.4%的病例在最初就诊机构确诊，而32.1%的病例在我院确诊。超过90%的肿瘤为高分化或高分化至中/低分化SCC。确诊所需的活检次数与转诊延迟时间显著相关（相关系数：0.3122，p = 0.0192）。作为代表性病例，展示了2例角化性SCC，其确诊具有挑战性。
外耳道SCC的早期诊断依赖于全面的活检评估。鉴于该肿瘤高分化的倾向，获取具有明确恶性特征的活检样本对于准确、及时地做出明确诊断至关重要。
