BackgroundNeuroendocrine adenomas of the middle ear are rare benign tumors deriving from middle ear mucosal cell with both neuroendocrine and epithelial properties. Approximately one hundred cases have been reported in the literature. Here we report a patient with neuroendocrine adenoma of the middle ear with the history of otitis media; the patient earlier had received radiotherapy for the treatment of basal cell carcinoma.Case presentationA 49- year- old Saudi man presented with a progressive hearing loss and fullness in the left ear with the history of otitis media for which he had undergone myringotomy and ventilating tubes insertion. Earlier at the age of 45 years this patient was given radiotherapy for the treatment of basal cell carcinoma in his cheek. The otoscopy showed a protruded external ear mass obscuring the tympanic membrane. Microscopy and histological examination suggested an endocrine adenoma of the middle ear. The computerized tomography scan of the temporal bone showed an extensive soft tissue mass without any osteolysis. Histological and immunohistochemical examination following surgical excision confirmed the diagnosis of neuroendocrine adenoma of the middle ear.ConclusionA rare case of neuroendocrine adenoma of the middle ear with earlier history of otitis media and carcinoma of the cheek is presented here. Surgical excision of mass resulted in uneventful recovery. Although the etiologic factors leading to the disease is far from clear, the role of radiotherapy given for the treatment of basal cell carcinoma may not be ruled out.

Ceruminous Adenoma (CA) is a benign neoplasm of ceruminous glands. Developing exclusively in the external auditory canal (EAC) with benign clinical behavior and was first reported by Hang in 1894. It is rare in humans and poses a diagnostic problem for the clinician, due to the variety of clinical presentations. This tumor is mainly composed of the ceruminous gland cells (modified apocrine sweat glands). These glands are localized deep in the skin mostly in the cartilaginous part of the external auditory meatus. We are presenting a 45 year old female patient who was referred to our otology department with a two year history of right ear blockage with progressive hearing loss, her other medical history was unremarkable. The surgical finding under microscope showed soft tissue mass under the skin that fulfilled half of the posterior inferior portion of the external auditory canal (EAC) that was completely excised under general anesthesia utilizing a postaurical approach. The excised tumor specimen after proper staining confirmed the diagnosis of ceruminous adenoma. In conclusion the CA is benign rear tumor raised from ceruminous gland in EAC slowly growing when getting bigger can block the EAC leading to heating loss; it can be presented with variety of symptom such as mild otolgia, ear blockage sensation and hearing loss treatment of choice is complete excision along with over line skin to prevent recurrence.

Bezold's abscess (BA) is a severe and rare extracranial complication of suppurative acute mastoiditis. The diagnosis of BA requires a high index of suspicion due to its rarity. In this study, we present a rare case of BA, in addition to a review of literature over 20 years. We searched for all cases in English literature from 2000 to 2020 in PubMed and found 27 cases (28 cases including the current case). BA was more prevalent in males (17/28, 60.7%) and adults (17/28, 60.7%). Of the 28 cases, six were associated with cholesteatoma and another six cases occurred with concomitant sinus thrombosis.

Background: Primary external auditory canal (EAC) malignancies are very rare with adenoid cystic carcinoma (ACC) representing approximately 5% of these tumors. There is insuffi cient knowledge of the natural behavior of ACC in EAC. The disease needs early detection and complete treatment because of its tendency to recur, vicinity to sensitive organs and lower response to radiation. Case presentation: In this case study, we presented a case of young female (37 years old) with right external auditory canal (EAC) mass which was diagnosed as benign tumor, postoperative biopsy confi rmed it as ACC of the EAC which is a rare case in the literature. Conclusion: Here, we report a rare case of Adenoid Cystic Carcinoma (ACC) of External Auditory Canal (EAC) in a 37 years old Saudi female. Initial, Clinical and CT fi ndings were suggestive of a benign cystic mass but histopathology examination confi rmed that tumor was ACC of EAC. The patient underwent to radical excision of the tumor along the parotidectomy. Postsurgical recovery was uneventful with no sign of recurrence until two years of follow up.

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