Congenital cholesteatoma tract presenting as a postaural swelling

Area of Science:

• Otolaryngology
• Pediatric Surgery
• Pathology

Background:

• Congenital cholesteatoma is a rare condition.
• Postaural lesions in children can be misdiagnosed.
• Epidermoid cysts are common differential diagnoses.

Purpose of the Study:

• To report a unique case of congenital cholesteatoma.
• To highlight its presentation mimicking an epidermoid cyst in a child.
• To discuss the clinical, radiological, surgical, and histological features.

Main Methods:

• Case report of a three-year-old boy.
• Surgical exploration and excision.
• Histopathological examination of the excised tissue.
• Review of clinical and radiological findings.

Main Results:

• A fistulous connection was found between the excised postaural lesion site and a congenital cholesteatoma sac in the mastoid.
• The congenital cholesteatoma had eroded through the mastoid bone to the subcutaneous tissues.
• The presentation mimicked a post-operative epidermoid cyst.

Conclusions:

• Congenital cholesteatoma can rarely erode through the mastoid bone.
• This presentation can mimic other conditions like epidermoid cysts in pediatric patients.
• Early diagnosis and appropriate surgical management are crucial.