Ear
External ear tumors - benign / nonneoplastic
Ceruminous adenoma
Author: Nat Pernick, M.D.
Last author update: 1 November 2014
Last staff update: 12 December 2024
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Ceruminous adenoma
Table of Contents
Definition / general | Case reports | Treatment | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Differential diagnosis | Additional referencesCite this page: Pernick N. Ceruminous adenoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/earceruminalglandadenoma.html. Accessed December 26th, 2024.
Definition / general
- Arise from cerumen secreting modified apocrine glands of external auditory canal
- Uncommon in general but most common external auditory canal tumor in outer portion where ceruminal glands exist
- Slightly more common in men, mean age 52 - 54 years, range 12 - 85 years
- Location of tumor (parotid gland, middle ear, external auditory canal) is important because treatment differs
- Term ceruminoma is obsolete
- Symptoms: slow growing external auditory canal mass or blockage with conductive hearing loss
Case reports
- 37 year old woman with expansion of an ceruminous adenoma into the middle ear (Laryngorhinootologie 2006;85:444)
Treatment
- Complete surgical excision
- Recurrences are due to incomplete excision
Gross description
- Skin covered, circumscribed, polypoid or rounded mass, gray-white-pink, 0.4 to 2 cm
- Usually not ulcerated
- Specimens are usually received by pathologist in small fragments without obvious surface epithelium
Microscopic (histologic) description
- Unencapsulated but well circumscribed glandular proliferations in cribriform, solid, cystic or papillary patterns
- Glands composed of inner cuboidal or columnar cells with eosinophilic cytoplasm and apical snouts (decapitation type secretion) and outer spindled myoepithelial cells with hyperchromatic nuclei
- Inner cells contain yellow-brown granular cerumen pigment
- Hyalinized stroma present
- No prominent pleomorphism or mitotic figures, no invasion or necrosis
Microscopic (histologic) images
Positive stains
Differential diagnosis
- Ceruminal adenocarcinoma:
- More infiltrative; perineural invasion, irregular gland formation, pleomorphism with prominent nucleoli, increased mitotic figures including atypical mitotic figures, tumor necrosis
- Usually no ceruminous granules
- Middle ear adenoma
- Paraganglioma:
- Nested pattern of paraganglia cells supported by sustentacular cells
- Chromogranin+, S100+
- Parotid gland tumor
Additional references
