Trichoepithelioma of the External Auditory Canal Mimicking Cholesteatoma

Trichoepithelioma is a benign tumor arising from hair follicles that most commonly appears on the face and is rarely seen in the external auditory canal (EAC). This case describes a male aged 90 years or older who presented with purulent ear drainage and hearing loss and was found to have trichoepithelioma in the EAC. Initial imaging and clinical examination suggested cholesteatoma in the EAC with bony erosion, for which surgical intervention was indicated. However, final pathology based on more extensive tissue sampling revealed trichoepithelioma of the anterior wall of the right EAC. This case demonstrates that suspicious lesions of the EAC may require more extensive tissue sampling to prevent misdiagnosis based solely on superficial tissue samples.