Metastatic Pancreatic Cancer Diagnosed From a Lesion in the External Auditory Canal

Metastases to the external auditory canal (EAC) are extremely rare and most often arise from breast, renal or lung carcinoma. To our knowledge, this is the first case of metastatic pancreatic adenocarcinoma to the EAC. A 34-year-old male patient, a smoker, presented with a 15-month history of right otalgia, otorrhoea, and hearing loss. Examination revealed a large, fleshy, and friable EAC lesion suspicious for neoplastic aetiology. Biopsy reported poorly differentiated adenocarcinoma. Subsequent imaging revealed a large pancreatic head mass, confirming a diagnosis of metastatic pancreatic adenocarcinoma. Although metastatic tumours to the EAC are rare, the differential should be considered when managing patients with EAC lesions. Detailed assessment, including biopsy and imaging, should be undertaken promptly if the presentation is suspicious.