title: A Melanocytic Lesion Extending From the Right Ear to the Nasopharynx in a Pediatric Patient: A Case Report.
abstract: BACKGROUND
  Blue nevus is a benign dermal melanocyte tumor that mainly arises from the skin. We report an extremely rare case of blue nevus in a pediatric patient with extensive progression from the middle ear and inner ear to the nasopharynx through the Eustachian tube.
  
  
  METHODS
  A 2-year-old girl with blue tympanum was referred to our department. Computed tomography scans and magnetic resonance imaging were performed, followed by a tissue biopsy and histopathologic evaluations. Radiologic examinations revealed that the lesion had progressed beyond the middle ear into the inner ear and the nasopharynx through the Eustachian tube. Subsequent histopathologic examinations indicated dermal dendritic melanocytic proliferations, but no evidence of malignancy. Based on the clinical and histopathologic findings, we concluded that the lesion was consistent with blue nevus.
  
  
  CONCLUSIONS
  Blue nevus is a relatively common skin lesion. However, no prior reports have described the extension of blue nevus from the auditory organ to the nasopharynx in a pediatric patient. Despite the benign nature of the lesion, the patient experienced profound hearing loss in the affected ear, which necessitates continued monitoring as the lesion may expand with patient growth.
authors: Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, School of Medicine, Tochigi, Japan.
authors: Chizu
authors: C
authors: Saito
authors: Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, School of Medicine, Tochigi, Japan Department of Otolaryngology, Hospital, National Rehabilitation Center for Persons with Disabilities, Saitama, Japan ishikawa-kotaro@rehab.go.jp.
authors: Kotaro
authors: K
authors: Ishikawa
authors: Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, School of Medicine, Tochigi, Japan.
authors: Ken-Ichi
authors: K
authors: Nakamura
authors: Department of Radiology, Jichi Medical University, School of Medicine, Tochigi, Japan.
authors: Akifumi
authors: A
authors: Fujita
authors: Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan.
authors: Michio
authors: M
authors: Shimizu
authors: Department of Diagnostic Pathology, Jichi Medical University Hospital, Tochigi, Japan.
authors: Noriyoshi
authors: N
authors: Fukushima
authors: Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, School of Medicine, Tochigi, Japan.
authors: Hiroshi
authors: H
authors: Nishino
authors: Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University, School of Medicine, Tochigi, Japan Department of Otolaryngology, Ishibashi General Hospital, Tochigi, Japan.
authors: Keiichi
authors: K
authors: Ichimura
mesh_terms: D001301:Audiometry, Pure-Tone / Q000379:methods; D001706:Biopsy; D049109:Cell Proliferation; D002675:Child, Preschool; D003937:Diagnosis, Differential; D018450:Disease Progression; D007758:Ear, Inner / Q000473:pathology; D004432:Ear, Middle / Q000473:pathology*; D005064:Eustachian Tube / Q000473:pathology; D016057:Evoked Potentials, Auditory, Brain Stem; D005260:Female; D046088:Hearing Loss, Unilateral / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007801:Langerhans Cells / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008544:Melanocytes / Q000473:pathology; D008991:Monitoring, Physiologic; D009305:Nasopharynx / Q000473:pathology*; D018329:Nevus, Blue / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D012878:Skin Neoplasms / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed / Q000379:methods; D018058:Tympanic Membrane Perforation / Q000175:diagnosis / Q000209:etiology
keywords: blue nevus; inner ear; malignant melanoma; melanocyte; middle ear; pharynx