External ear tumors - benign / nonneoplastic

Ceruminous adenoma

Topic Completed: 1 November 2014

Minor changes: 1 March 2021

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: ceruminous adenoma

Nat Pernick, M.D.
Page views in 2020: 1,836
Page views in 2021 to date: 2,315
Cite this page: Pernick N. Ceruminous adenoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/earceruminalglandadenoma.html. Accessed December 8th, 2021.
Definition / general
  • Arise from cerumen secreting modified apocrine glands of external auditory canal
  • Uncommon in general but most common external auditory canal tumor in outer portion where ceruminal glands exist
  • Slightly more common in men, mean age 52 - 54 years, range 12 - 85 years
  • Location of tumor (parotid gland, middle ear, external auditory canal) is important because treatment differs
  • Term ceruminoma is obsolete
  • Symptoms: slow growing external auditory canal mass or blockage with conductive hearing loss
Case reports
  • Complete surgical excision
  • Recurrences are due to incomplete excision
Gross description
  • Skin covered, circumscribed, polypoid or rounded mass, gray-white-pink, 0.4 to 2 cm
  • Usually not ulcerated
  • Specimens are usually received by pathologist in small fragments without obvious surface epithelium
Microscopic (histologic) description
  • Unencapsulated but well circumscribed glandular proliferations in cribriform, solid, cystic or papillary patterns
  • Glands composed of inner cuboidal or columnar cells with eosinophilic cytoplasm and apical snouts (decapitation type secretion) and outer spindled myoepithelial cells with hyperchromatic nuclei
  • Inner cells contain yellow-brown granular cerumen pigment
  • Hyalinized stroma present
  • No prominent pleomorphism or mitotic figures, no invasion or necrosis
Positive stains
Differential diagnosis
  • Ceruminal adenocarcinoma: more infiltrative; perineural invasion, irregular gland formation, pleomorphism with prominent nucleoli, increased mitotic figures including atypical mitotic figures, tumor necrosis; usually no ceruminous granules
  • Middle ear adenoma
  • Paraganglioma: nested pattern of paraganglia cells supported by sustentacular cells; chromogranin+, S100+
  • Parotid gland tumor
Additional references
Back to top
Image 01 Image 02