Pseudocyst of the auricle: an uncommon entity of the ear

A 48-year-old white man presented with a 2-month history of a lump on his right ear following purported exposure to the cold. The patient denied any history of trauma, rubbing, insect bite, or inflammation at the site. The patient was otherwise healthy and was not taking any medications. The lesion was completely asymptomatic, as the patient denied any pain, tenderness, or change in size since the lesion appeared. Physical examination revealed a 1.1-cm x 1-cm skin-colored, slightly fluctuant, rubbery, nonmobile dermal nodule on the right scaphoid fossa (Figure 1). No erythema, warmth, tenderness, or drainage was noted. A review of systems was noncontributory. A punch biopsy performed at the site of the cyst yielded clear, serous drainage. The cystic lesion was drained completely and decompressed. Histological examination revealed the surface of an intracartilaginous cystic space lined by degenerated cartilage, consistent with a diagnosis of pseudocyst of the auricle (Figure 2 and Figure 3). The lesion, although much smaller than at the time of presentation, persisted at the 3-week follow-up visit. It remained asymptomatic, without pain or irritation. At that time, the patient declined re-excision with bolster dressing. At 7-month follow-up, he reported the lesion to be stable.