A solitary painful papule on the ear

Abstract

An 80-year-old woman presented with a slowly enlarging, intermittently painful lesion on the upper part of her right ear. It had been present for 2 years. On examination, there was a discrete, firm, translucent papule, 7 · 4 mm in size, on the posterior aspect of the upper crus of the antihelix of the right ear. A single prominent blood vessel was visible on the surface of the lesion and it was tender to palpation ( Fig. 1).

Schwannoma of the Auricle

“…Histologically, the 2 distinctive patterns of highly cellular Antoni A areas and hypocellular Antoni B areas are a microscopic hallmark of schwannomas (1,3,4). Antoni A areas gradually degenerate to Antoni B areas; therefore, the tumor can become softer rather than firmer, which may give it a consistency similar to a lipoma or epidermal cyst on palpation, such as in the present case.…”

“…Schwannomas in the head and neck usually present as painless lumps, with seldom primary involvement of the external ear. To our knowledge, only 3 cases of auricular schwannoma have been described thus far (3,4). In our current report, we describe a further rare case of a schwannoma that arose from the auricle.…”

“…Neurofibromas originate from Schwann cells but do not have a true capsule and histologically have no Verocay bodies (1). In the cutaneous region, the histologic differential diagnosis is a solitary circumscribed neuroma, which is incompletely encapsulated, has ill-defined nuclear palisades, and in contrast to schwannomas, contains no Antoni B areas (4).…”

Cutaneous Schwannoma Presented as a Pedunculated Protruding Mass

“…The histological differential diagnosis includes palisaded and encapsulated neuroma (PEN) and neurofibroma5. It is especially important to differentiate superficially located schwannoma from PEN, because PEN is encapsulated, located in the upper dermis, and the patterns of interlacing fascicles can be similar to Antoni A of a schwannoma.…”

Enlarging Neck Mass in an Adolescent Boy

“…Histopathology will reveal an encapsulated mass with a biphasic appearance consisting of Antoni A and Antoni B areas . Antoni A areas demonstrate highly ordered spindle cells arranged in compact fascicles with palisading nuclei .…”