Cancer of the auricle

Thirty-five patients with carcinoma of the auricle seen in Veterans General Hospitals, Taipei and Taichung from January 1970 to December 1988 were reviewed retrospectively. There were 28 men and 7 women. More cases occurred in the 7th and 8th decades with an average of 64 years (median 67) and ranged from 29 to 91 years. The most common manifestations at diagnosis were exophytic mass (86%) and/or ulcerative lesion (29%). Histologically, basal cell carcinoma outnumbered squamous cell carcinoma 17 to 14. The remaining 4 cases consisted of 2 melanomas, 1 sweat gland adenocarcinoma and 1 unclassified sarcoma. Eighty-eight percent (15/17) of basal cell carcinoma presented at early stage without regional lymph node or distant metastasis. They were mainly treated by surgery. One patient with multifocal lesions suffered from marginal recurrence. The 2 and 5-year survival rates were 94% and 86% respectively. Half of our 14 patients with squamous cell carcinoma had local extensive tumor but no lymph node or distant metastasis was found at the time of diagnosis. Local recurrence occurred in 4 patients, one case associated with lung metastasis. The local control rate of combined surgery and irradiation in squamous cell carcinoma was 100% (4/4), superior than that of operation alone 67% (6/9) or radiotherapy alone (0/1). The actual 2 and 5-year survival rates were 85% and 64% respectively. Our 4 patients with different pathology other than basal cell or squamous cell carcinoma had high rate of regional lymph nodes or distant metastases, presenting poor prognosis. The overall treatment failure for carcinoma of the auricle was 23% (8/35) but reduced to 14% after salvage treatment.(ABSTRACT TRUNCATED AT 250 WORDS)