Intracranial invasion from a primary adenocarcinoma arising in the middle and external ear

Cerumenal adenocarcinoma is a rare neoplasm arising from the modified sweat glands of the ear. Before the diagnosis of primary tumour is made, a thorough search must be undertaken to exclude the possibility of metastatic disease, which occurs more commonly. Benign adenoma can also occur and this may be identical histologically to the malignant variety. The presence of local invasiveness may be the only differentiating feature. Aggressive local resection followed by postoperative radiotherapy form the cornerstone of management. Individuals treated with radiotherapy alone have a life expectancy of less than 12 months whereas cures have been reported with radical surgery.