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Adenoid Cystic Carcinoma of the External Auditory Canal

Authors

  • Fei Dong BS,

    1. Case Western Reserve University School of Medicine Cleveland, Ohio, U.S.A.
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  • Paul W. Gidley MD,

    1. From the Departments of Head and Neck Surgery The University of Texas M.D. Anderson Cancer Center, Houston, Texas, U.S.A.
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  • Tang Ho MD,

    1. From the Departments of Head and Neck Surgery The University of Texas M.D. Anderson Cancer Center, Houston, Texas, U.S.A.
    2. Department of Otolaryngology-Head and Neck Surgery Baylor College of Medicine, Houston, Texas, U.S.A.
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  • Mario A. Luna MD,

    1. Pathology The University of Texas M.D. Anderson Cancer Center, Houston, Texas, U.S.A.
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  • Lawrence E. Ginsberg MD,

    1. Diagnostic Radiology The University of Texas M.D. Anderson Cancer Center, Houston, Texas, U.S.A.
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  • Erich M. Sturgis MD, MPH

    Corresponding author
    1. From the Departments of Head and Neck Surgery The University of Texas M.D. Anderson Cancer Center, Houston, Texas, U.S.A.
    2. Epidemiology The University of Texas M.D. Anderson Cancer Center, Houston, Texas, U.S.A.
    • Send correspondence to Erich M. Sturgis, MD, MPH, Department of Head and Neck Surgery, Unit 441, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030
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  • Editor's Note: This Manuscript was accepted for publication April 16, 2008. Awarded poster first place award at the Southern Section of the Triological Society, Naples, Florida, January 10–12, 2008.

Abstract

Objective/Hypothesis: To describe the clinical history and outcome of patients with adenoid cystic carcinoma (ACC) of the external auditory canal (EAC).

Study Design: Retrospective case series.

Methods: A search of our institution's tumor registry identified 22 patients with ACC of the EAC. Both clinical histories and pathology slides, when available, were reviewed.

Results: The mean age at diagnosis was 42 years (median, 38.5 years), and the most common presenting complaints were otalgia and ear canal mass. Nine patients (41%) developed recurrences at a mean of 8 years (median, 8 years) after initial diagnosis, six died of ACC, and three were living with distant metastases at their last follow-up. The mean duration of symptoms at the time of diagnosis was 7.7 years (range, 2–30 years) for patients who developed a recurrence after treatment vs. 1.2 year (range, 0–2 years) for patients who remained disease-free (P = .137). Every patient who had recurrent disease reported a duration of symptoms of ≥2 years (P = .013), and every patient with a duration of symptoms >2 years recurred (P = .002). There was a trend for more local recurrences after limited resection (P = .061).

Conclusions: ACC of the EAC often recurs many years after definitive treatment. Although our sample size was too small to make definitive conclusions, we recommend aggressive local therapy with lateral temporal bone resection and adjuvant postoperative radiotherapy. In addition to successful local therapy, early diagnosis may be the only other effective means of preventing distant metastases.

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