In comparison with cases of benign tumor, a statistically significantly greater number of repeated biopsies were required in cases diagnosed as malignant tumors to confirm the pathological diagnosis or when there was continued suspicion of malignancy. Therefore, when there is clinical suspicion, even if there are no findings of malignancy on the first biopsy, the biopsy should be repeated expeditiously.

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ÖZEksternal otit dış kulak yolu ve aurikulanın enflamasyonu ile karakterize sık görülen bir durumdur. Tedavi için kullanılan topikal ajanlar kontakt dermatite neden olabilir. Bu yazıda, sağlık ocağı biriminde akut eksternal otit tanısı ile gentamisin tedavisi başlanan ancak tedavisinin üçüncü gününde kulağında siyah renkli lezyonlar, ağrı ve akıntı yakınması ile kliniğimize başvuran 48 yaşında bir erkek hasta sunuldu. Fizik muayenesinde dış kulak yolu kıkırdak kısmında ve kavum konkada yaygın cilt nekrozu görüldü. Malign eksternal otit ön tanısı ile yüksek rezolüsyonlu temporal kemik bilgisayarlı tomografisi çekildi. Kulak kültürü ve nekrotizan alandan biyopsi yapıldı. İntravenöz piperasilin-tazobaktam tedavisi başlandı. Radyolojik ve kültür inceleme sonuçlarının normal çıkması üzerine topikal gentamisin uygulamasına bağlı şimik reaksiyon düşünüldü. Debridman ve yara bakımının ardından hasta komplikasyonsuz taburcu edildi. Dış kulak yolunda ve aurikulada yaygın nekroz ile başvuran hastalarda ayırıcı tanıda ilk olarak yüksek mortalite ve morbidite oranları nedeniyle malign eksternal otit ekarte edilmeli ve aynı klinik tabloya neden olabilecek ilaç reaksiyonları göz ardı edilmemelidir.Anahtar Sözcükler: Alerjik kontakt dermatit; auriküler nekroz; gentamisin. ABSTRACTExternal otitis is a common condition characterized by inflammation of external auditory canal and auricle. Topical agents used for treatment may cause contact dermatitis. In this article, we present a 48-year-old male patient admitted to our clinic with complaint of black colored lesions, pain, and discharge on his ear on third day after the start of gentamicin treatment by a primary health care unit due to a diagnosis of acute external otitis. In physical examination, we observed widespread skin necrosis on cartilage part of external auditory canal and cavum conchae. High resolution computed tomography of the temporal bone was performed with a prediagnosis of malignant external otitis. Ear culture and biopsy from the necrotic region were conducted. Intravenous piperacilline-tazobactam treatment was started. Upon normal results from radiologic and culture examinations, we considered a chemical reaction due to topical gentamicin application. Patient was discharged after debridement and wound care without any complications. Because of its high morbidity and mortality rates, malignant external otitis should be the first to eliminate in the differential diagnosis in patients that apply with widespread necrosis on external auditory canal and auricle and drug reactions that may cause the same clinical picture should not be ignored.

ABS TRACT Pseudomyogenic hemangioendothelioma (PHE) is a rare neoplasm with vascular origin mostly seen on the extremities. Up to date, the terminology which represents PHE has been a subject to debate. According to the World Health Organization, PHE is classified among the soft tissue tumors. PHE is mostly seen in soft tissue planes and the distal lower extremities are the most affected location of the body. Localization of this tumor on the head and neck region is uncommon. PHE, being a sarcoma does not favor lymphogenic metastasis. As far as we are concerned, this is the first described case of PHE of the external ear and retro auricular sulcus. In this paper, the management of this case and the current treatment options of PHE are discussed.