Angioleiomyoma of the External Auditory Canal in a Pediatric Patient: A Case Report

Angioleiomyoma (ALM) is a subtype of leiomyoma characterized by vascular involvement alongside the proliferation of smooth muscle cells. These tumors are generally found in the lower limb and rarely occur in the head and neck region. Herein, we present a rare case of ALM of the external auditory canal (EAC) in a 12-year-old female. To our knowledge, this is the sixth case and the second youngest patient reported with ALM occurring in the EAC. Initially, this patient was diagnosed with otitis externa with polypoid change and prescribed a course of Ciprodex. Follow-up CT demonstrated a soft tissue density in the right EAC, consistent with medial canal fibrosis, and an exam under anesthesia with local excision of the mass was scheduled. Surgical findings showed a cartilaginous, firm mass originating from the fissure of Santorini that was carefully excised completely along with an EAC cholesteatoma seen lateral to the tympanic membrane. The foramen of Huschke was uninvolved and the tympanic membrane was intact without perforation. Final pathology confirmed benign ALM. The EAC was packed with floxin-soaked gelfoam and left packed for 2 weeks with instructions for daily floxin drop placement. Once the gelfoam was removed in the clinic, the EAC was found to be healing well and the patient noted improved subjective hearing. There has not been any subsequent recurrence over a period of 5 months. This case documents a rare presentation of an ALM in an extremely rare anatomical position which was managed successfully.