Capillary hemangioma of the tympanic membrane

doi:10.1016/j.amjoto.2005.02.006

American Journal of Otolaryngology

Volume 26, Issue 5, September–October 2005, Pages 351-352

https://doi.org/10.1016/j.amjoto.2005.02.006 Get rights and content

Abstract

We report a case of capillary hemangioma of the tympanic membrane in a 51-year-old man with conductive hearing loss, otalgia, and otorrhea. On examination, the external auditory canal was obstructed with a hard, dark red tumor, and purulent discharge was observed. The infection was controlled with antibiotics, but hearing loss persisted. Therefore, transcanal resection was performed. The tumor was attached to the postero-superior quadrant, and arose from the lamina propria. Histologically, the tumor was composed of multiple capillary-sized vessels surrounded by fibrous connective tissue and diagnosed as capillary hemangioma. After surgical treatment, hearing loss was diminished, and there has not been any sign of recurrence for 3 years despite the positive surgical margin.

Introduction

Hemangioma is a common vascular lesion, but it rarely occurs in the tympanic membrane. Most of the reported cases of hemangioma of the tympanic membrane were cavernous hemangiomas. To our knowledge, only 4 cases of capillary hemangiomas have been reported in the English medical literature [1], [2], [3], [4]. All 4 cases arose from the postero-superior quadrant, and 2 cases were asymptomatic. We report a case of capillary hemangioma of the tympanic membrane that was accompanied by conductive hearing loss, otalgia, and otorrhea.

Section snippets

Case report

A 51-year-old man presented with a 2-month history of right otalgia and otorrhea. He also noticed right hearing loss 8 months before the onset. Otoscopic examination demonstrated a hard and dark red tumor occluding the external auditory canal (Fig. 1). Purulent discharge was observed around the tumor, and Staphylococcus aureus was isolated on culture. Pure tone audiogram showed right conductive hearing loss with an air-bone gap of 35 dB. The infection was controlled with antibiotics, and

Discussion

Hemangiomas are benign vascular lesions that are most common in infancy and childhood. There are several histological and clinical variants. Capillary hemangiomas are composed of capillary-sized blood vessels. They are bright red to blue, on a level with the surface of the skin, or slightly elevated. Occasionally, peduncled lesions are formed, attached by a broad-to-slender stalk [5]. They are usually seen in the skin, subcutaneous tissues, and oral mucosa [5], and rarely occur in the tympanic

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Cited by (28)

Middle ear capillary haemangioma: Review of literature and appraisal of management options
2016, Auris Nasus Larynx
Infantile middle ear capillary haemangiomas (MECH) are a rare entity with only five reported cases in the literature. At present there is no consensus regarding the management of such lesions. Extra-cutaneous haemangiomas have been successfully managed with oral propranolol but not yet reported in MECH. We present a further case and appraise the management options. At present oral propranolol has not been used in the treatment of MECH.
The literature suggests that infantile MECH have a higher propensity to spontaneously involute and a greater likelihood of response to propranolol. Surgical excision is the best option in older children and adults.
Hemangioma of the external auditory canal in an adolescent male: Report of a case and review of the literature
2013, International Journal of Pediatric Otorhinolaryngology Extra
Citation Excerpt :
The lesion was diagnosed as a venous hemangioma. Hemangiomas involving the EAC and the tympanic membrane (TM) [3–7] or simply the TM alone [8–14] are rare entities. Those confined exclusively to the EAC are just as infrequent, with only nine cases being previously described in the literature (Table 1) [15–23].
Hemangiomas confined exclusively to the external auditory canal (EAC) are rare, with only nine cases being described in the literature. We report a case of a hemangioma causing conductive hearing loss in a 15-year-old male. This is the first case of a hemangioma isolated to the EAC in an adolescent and the first to be described as being of the venous subtype. Imprecise terminology has historically made the diagnosis and classification of these lesions difficult. We use this opportunity to not only shed light upon this unique case, but to briefly compare current classification schemes and review the literature relating to hemangiomas involving the EAC.
Capillary hemangioma of the tympanic membrane
2011, American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Capillary Hemangioma of the Middle Ear and External Auditory Canal: a Case Report
2010, Journal of Otology
We report a case of capillary hemangiomsa that involved the entire middle ear space, external auditory canal(EAC) and tympanic antrum. Symptoms in the case included ear fullness, hearing loss, otalgia and otorrhea. The case was misdiagnosed as recurrent chronic otitis media with granulation preoperatively. A diagnosis of capillary hemangioma was established by postoperative histological examination. The management of capillary hemangioma of the middle ear and external auditory canal is discussed, with a review of the literature. Because of its variable and sometimes misleading clinical presentation, hemangioma can initially be misdiagnosed as other lesions. Therefore, a high index of suspicion is necessary for early and accurate diagnosis.
Hemangiomas of the external auditory canal
2010, American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Citation Excerpt :
Hemangiomas of the external auditory canal are rare. With the addition of our case, only 17 cases have been described in the literature (Table 1) [2-17]. Patients may be asymptomatic at presentation with only a lesion involving the external auditory canal, tympanic membrane, or both, or may present with symptoms ranging from blood-tinged otorrhea to conductive hearing loss.
Hemangiomas of the external auditory canal are rare with only 16 cases reported in the literature. We report the case of a 62-year-old woman who presented with bleeding from the external auditory canal. Physical examination and imaging were consistent with a hemangioma. Initial diagnostic evaluation failed to reveal the full extent of the lesion resulting in recurrence after primary local excision. After recurrence, the hemangioma was managed successfully with embolization and a more extensive resection. In addition, we review the relevant literature with respect to epidemiology, presentation, evaluation, pathology, and management options for hemangiomas arising in the external auditory canal.
Fibroma of the tympanic membrane
2009, American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Citation Excerpt :
Disease of the tympanic membrane, including a mass lesion, is one of the possible causes. However, a primary tumor of the tympanic membrane is very rare, and only a few cases have ever been reported in the English literature, for example, hemangioma, schwannoma, paraganglioma, and squamous cell carcinoma [1-4]. These tumors may cause symptoms such as hearing loss, otalgia, otorrhea, and sometimes asymptomatic conditions.
A primary tumor of the tympanic membrane is very rare. Herein, we describe a patient with a thick tympanic membrane that caused progressive hearing loss. The patient was treated with total resection of the tympanic membrane and was diagnosed with fibroma after histopathologic examination. There was no evidence of recurrence 2 years after the operation, and the patient's hearing was normal. Fibroma may arise in the tympanic membrane and should be regarded as a possible cause of the mass of the tympanic membrane.

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Case reportCapillary hemangioma of the tympanic membrane

Abstract

Introduction

Section snippets

Case report

Discussion

Otolaryngol Head Neck Surg

Otolaryngol Head Neck Surg

Am J Otolaryngol

Case report
Capillary hemangioma of the tympanic membrane