ABSTRACT
@#A 58-year-old Filipino man with a two-year history of a left external auditory canal mass associated with ipsilateral hearing loss underwent polypectomy for a clinical impression of aural polyp. We received several cream tan, irregular tissue fragments with an aggregate diameter of 1.4 cm. Histopathologic examination shows clusters of tumor cells forming variably sized ducts and glands, some of which are cystically dilated; many of these structures have irregular lumina. (Figure 1) Higher magnification shows a dual cell population: an outer layer of round to ovoid cells with clear cytoplasm, corresponding to basal myoepithelial cells; and an inner layer of cuboidal to columnar cells, that have eosinophilic and granular cytoplasm with decapitating apical ends, corresponding to luminal epithelial cells with apocrine morphology. (Figure 2) Nuclear pleomorphism is mild to moderate, nucleoli are not prominent, and mitoses, perineural invasion and necrosis are not seen. In some glands a yellow to golden brown, coarse pigment is seen at the cytoplasm of the luminal cells. (Figure 3) The tumor does not involve the epidermis, and there is a variable amount of chronic inflammation. (Figure 4) Based on these features we diagnosed it as ceruminous adenoma.