Ceruminous adenoma

Definition

These are tumours of the external auditory canal, arising from ceruminous glands.

Synonyms

Ceruminoma, hidroadenoma, adenoma ceruminalis, and many others.

Epidemiology

This is a tumour of adults.

Clinical features

Patients usually present with a tumour in the outer half of the external auditory canal.

Radiology

Macroscopic appearances

The tumours are circumscribed but not encapsulated. When removed intact, they are polypoidal.

Histopathology

• Ceruminous adenoma: cells are arranged in a glandular pattern, often with cystic dilatation. Less often, there is a papillary or solid pattern. Epithelial cells may "invade" the stroma. The epithelial cell layer consists of luminal epithelial cells and basal/myoepithelial cells.

• Ceruminous pleomorphic adenoma: a more prominent myoepithelial layer combined with a myxoid-chondroid stroma.

• Syringocystadenoma papilliferum: papillary projections into a cystic lumen.

Golden yellow-brown pigment granules are present.

Immunohistochemistry

Ultrastructure

Differential diagnosis

• Ceruminous adenocarcinoma; show infiltration, including perineural, irregular gland formation, pleomorphism, mitoses and necrosis. They usually lack ceroid pigment.

• Glandular neoplasms of the middle ear: exclude by accurate anatomical location

  • neuroendocrine adenoma of the middle ear

  • endolymphatic sac tumour

• Glandular neoplasms of the parotid: : exclude by accurate anatomical location.

• paraganglioma

• meningioma

Management

Prognosis

This is a benign neoplasm. Some tumours recur locally.

References

1Thompson, L. D., B. L. Nelson, et al. (2004). "Ceruminous adenomas: a clinicopathologic study of 41 cases with a review of the literature." Am J Surg Pathol 28(3): 308-18.

This page last revised 25.3.2004.

©SMUHT/PW Bishop