Verrucous carcinoma in the external auditory canal

The apparent rarity of verrucous carcinomas of the ear is reflected by the fact that only three well-documented cases have previously appeared in the literature. However, in other instances the diagnosis of verrucous carcinoma may have been missed because of the unfamiliarity of many clinicians and pathologists with the morphologic characteristics of these lesions. We describe the first case of a verrucous carcinoma confined to the external auditory canal in which a positive diagnosis was only made histologically after local recurrence of what was initially diagnosed as a senile keratosis. The difficulties inherent in diagnosing this lesion and the necessity of close cooperation between the surgeon and pathologist if a diagnostic error is to be avoided are emphasized. Careful follow-up of all warty lesions of the external auditory canal and middle ear cleft is recommended.