title: External auditory canal paraganglioma: an atypical presentation.
abstract: OBJECTIVE
  We present the first published description of a painful paraganglioma of the external auditory canal. Atypical histopathology made the diagnosis difficult. We discuss the potential pitfalls of clinical diagnosis and treatment of such a case.
  
  
  METHODS
  A 49-year-old woman presented with left-sided otalgia, hearing loss and tinnitus. Physical examination revealed a firm swelling arising from the superior portion of the left external auditory canal. A clinical diagnosis of otitis externa was made.
  
  
  METHODS
  There was minimal response to medical treatment. The swelling was aspirated, leading to brisk bleeding. A tumour was suspected from the computed tomography scan, and confirmed by a biopsy. The patient underwent excision of the paraganglioma. The histopathology was atypical, making diagnosis difficult.
  
  
  CONCLUSIONS
  Such unusual masses of the external ear should always be borne in mind, especially when dealing with atypical presentations of commonly encountered diseases. Clinicians should have a low threshold for early intervention with imaging and biopsy.
authors.affiliation: ENT Department, Royal National Throat, Nose and Ear Hospital, London, UK. nancybatta@yahoo.com
authors.forename: N
authors.initials: N
authors.lastname: Grover
authors.forename: F
authors.initials: F
authors.lastname: Amen
authors.forename: A
authors.initials: A
authors.lastname: Gallimore
authors.forename: G
authors.initials: G
authors.lastname: Brookes
mesh_terms: D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D004424:Ear Canal; D004428:Ear Neoplasms / Q000175:diagnosis*; D004433:Earache / Q000209:etiology; D005260:Female; D006314:Hearing Loss, Conductive / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D010032:Otitis Externa / Q000209:etiology; D010235:Paraganglioma / Q000175:diagnosis*