External ear tumors - benign / nonneoplastic

Ceruminous adenoma

Last author update: 1 November 2014
Last staff update: 16 January 2023

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PubMed Search: Ceruminous adenoma

Nat Pernick, M.D.
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Cite this page: Pernick N. Ceruminous adenoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/earceruminalglandadenoma.html. Accessed June 4th, 2023.
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  • Term ceruminoma is obsolete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
Microscopic (histologic) images

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Ceruminous adenoma

Ceruminous adenoma

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
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