Rare manifestation of non-Hodgkin lymphoma of the head & neck following cochlear implant surgery

Lymphomas are the second most common malignant neoplasm in the head & neck region (H&N). This report describes a rare cutaneous manifestation of non-Hodgkin lymphoma (NHL) after cochlear implant (CI) surgery. A 71-year-old female presented to the university hospital with an ulcerative retroauricular lesion. The lesion had developed over a week at the site of prior incision for CI surgery 5 years ago and revision surgery due to device failure 16 months ago. The patient's history is notable for NHL with cervical lymphadenopathy and tonsillar manifestation treated with Ibrutinib. A delayed infection after CI surgery is suspected. Histopathologic examination shows infiltration of NHL cells. Lymphomas display variable clinical presentation in the head & neck. A history of trauma may delay the diagnosis. A locus minoris resistentiae may be created at those sites and allow lymphoma cells to accumulate. Thorough analysis of the patient's medical history is therefore crucial. Suspicious findings in the head and neck should be biopsied timely and a histopathologic examination should be conducted.