Malignant Melanoma of the External Auditory Canal:A Rare Entity

Document Type: Case Report


1 Department of Pathology, NEIGRIHMS, Shillong, India.

2 Department of Otorhinolaryngology, NEIGRIHMS, Shillong. India.


Although malignant melanomas (MM) are common in the head and neck region; primary malignant melanoma of the external auditory canal (EAC) is rare.
Case Report:
We present the case of a 50-year-old symptomatic man with a malignant melanoma of the external auditory canal, which clinically masqueraded as a haemangioma. The patient subsequently developed extensive loco-regional metastasis, requiring extensive surgery. We describe the clinical presentation, differential diagnosis, both clinical and pathological in terms of other pigmented lesions in the external auditory canal, detailed histopathology, and literature review.
We want to emphasize the importance of immediate and adequate biopsy of any pigmented lesion in the head and neck region to rule out  MM. Also, we emphasize the importance of deep biopsy for proper histopathological assessment in addition to distinguishing it from benign melanocytic nevi, in order to initiate treatment.


Main Subjects

1. Shashanka R, Smitha BR. Head and neck melanoma. ISRN Surg. 2012; 2012: 1-7

2. Bodenham DC. Malignant melanoma of the head and neck. In: Chambers RD (Ed.) Cancer of the head and neck.  Excerpta Medica, Amsterdam, 1975; 85-91

3. Byers RM, Smith JL, Russell N, Rosenberg V. Malignant melanoma of the external ear. Review of 102 cases.  Am J Surg. 1980: 140 (4); 518–21.

4. Jahn V, Breuninger H, Garbe C, Moehrie M. Melanoma of ear: prognostic factors and surgical strategies. Br J Dermatol. 2006:154(2); 310-8.

5. Gowthami C, Kumar P, Ravikumar A, Joseph L D, Rajendiran S. Malignant melanoma of external auditory canal. J Clin Diagn Res .2014: 8(8); 4-5.

6. Hannan SA, Parikh A. Malignant melanoma of the external ear canal. Lancet. 2006:368; 1680.

7. Lin CH, Tu TY, Chu PY, Chen YW. Malignant melanoma of the external auditory canal. Tzu Chi Med J. 2009: 21(3); 244-7.

8. Feng HM, Chen HC, Shi ZP, Chang YM, Wang CW. Cavernous Hemangioma of the External Auditory Canal: Two Case-Reports and a Literature Review. Int Adv Otol. 2013: 9(1); 126-30.

9. Martines F, Bentivenga D, Maira E, Marasa S, Ferrara S. Cavernous haemangioma of the external auditory canal: clinical case and review of the literature. Acta Otorhinolaryngol Ital. 2012; 32:

10. Verret DJ, Cochran SC, DeFatta RJ, Samy RN. External Auditory Canal Hemangioma: Case Report. Skull Base 2007: 17; 141–3.

11. Katarkar A, Jain A, Shah P, Shah M. A rare case of intradermal nevus of external auditory canal presenting with otorrhoea. Indian J Otol. 2011: 17(1); 20-1.

12. Wang F, Wu N, Hou Z, Liu J, Shen W, Han W et al. Diagnosis and treatment of rare malignant tumors in external auditory canal. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2015:29(16); 1438-42.

13. Zhen S, Fu T, Qi J. Diagnosis and treatment of carcinoma in external auditory canal. J Otol. 2014: 9; 146-50.

14. Milbrath MM, Campbell BH, Madiedo G, Janjan NA. Malignant Melanoma of the External Auditory Canal. Am J Clin Oncol. 1998: 21; 28-30.

15. Langman AW, Yarington CT, Patterson SD. Malignant melanoma of the external auditory canal. Otolaryngol Head Neck Surg.1996: 114(4); 645-8.

16. Ravin AG, Pickett N, Johnson JL, Fisher SR, Levin LS, Seigler HF. Melanoma of the ear: treatment and survival probabilities based on 199 patients. Ann Plast Surg. 2006:57(1);70-6.