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Journal of Feline Medicine and Surgery Apr 2022This study aimed to understand epidemiological factors associated with feline cystadenomatosis, including signalment and papillomavirus PCR status. Cystadenomatosis is...
OBJECTIVES
This study aimed to understand epidemiological factors associated with feline cystadenomatosis, including signalment and papillomavirus PCR status. Cystadenomatosis is an uncommon condition primarily involving the ceruminous and apocrine skin and ear glands.
METHODS
This was a retrospective case series. Clinical records from 2011 to 2019 from a tertiary referral hospital in Boston, MA, USA were screened for cases, and case data were re-evaluated and analyzed. The total patient pool contained 65,385 individual cats, of which 797 were referred to the dermatology service. Medical records and biopsy specimens were reviewed; the information collected included signalment, clinical signs, physical examination and diagnostic tests, comorbidities and histopathologic findings. PCR was performed on biopsy specimens to test for papillomavirus DNA.
RESULTS
The cystadenomatosis population consisted of 57 cases (7.1% of total cases referred to the dermatology service) with 105 affected ears. Twenty-seven cases (48 ears) were confirmed via histopathology; four cats (7%) exhibited clinically cystic lesions on the periocular, periorbital and perianal regions; only one cat did not have pinnal lesions. Domestic shorthair cats were most often affected. Relative risk for cystadenomatosis was 2.24 times higher in male cats. In 48 cats (84.2%), ears were bilaterally affected. Seven cats (12.3%) had malignant neoplasia, which included: inflamed adenocarcinoma (n = 5); mast cell tumor (n = 1); or squamous cell carcinoma (n = 1). PCR testing on biopsy specimens from 24 cats revealed feline papillomavirus type 2 DNA in only four cats.
CONCLUSIONS AND RELEVANCE
Cystadenomatosis was more prevalent in senior non-purebred cats, over-represented in male cats and did not appear to be associated with papillomavirus, feline infectious peritonitis, feline immunodeficiency virus/feline leukemia virus status or other identifiable illnesses. Further studies are needed to investigate the causes of cystadenomatosis.
Topics: Animals; Cat Diseases; Cats; Feline Infectious Peritonitis; Immunodeficiency Virus, Feline; Leukemia Virus, Feline; Male; Papillomaviridae; Retrospective Studies; Skin
PubMed: 34254846
DOI: 10.1177/1098612X211024498 -
Journal of Feline Medicine and Surgery Oct 2022Ear canal neoplasia is uncommon in cats. Ceruminous gland adenocarcinoma is the most frequently reported malignant neoplasm of the feline ear canal, and squamous cell... (Review)
Review
CASE SERIES SUMMARY
Ear canal neoplasia is uncommon in cats. Ceruminous gland adenocarcinoma is the most frequently reported malignant neoplasm of the feline ear canal, and squamous cell carcinoma (SCC) is the most common malignant neoplasm diagnosed in the feline middle ear. However, limited information exists on the outcome of cats diagnosed with SCC of the ear canal, middle or inner ear. Therefore, the objective of this study was to describe the outcome of cats diagnosed with SCC affecting these locations. Medical records were reviewed at multiple institutions to identify cats with a definitive diagnosis of SCC. Twenty-five cats were identified. Eleven cats were treated with surgery, eight with medical management, two with coarse fractionated radiation therapy, two with a combination of coarse fractionated radiation therapy and chemotherapy, one with a combination of surgery and coarse fractionated radiation therapy, one cat with systemic chemotherapy and one cat received no treatment following diagnosis. The median survival time of cats treated with surgery was 168 days vs 85 days ( = 0.28) for those treated palliatively with either medical management, radiation therapy, chemotherapy, or a combination of radiation therapy and chemotherapy.
RELEVANCE AND NOVEL INFORMATION
This case series documented that SCC of the ear canal, middle and/or internal ear is a locally aggressive tumor that carries an overall poor prognosis. The median survival time for cats treated with surgery was longer than that with any other modality, but this difference was not statistically significant.
Topics: Adenocarcinoma; Animals; Carcinoma, Squamous Cell; Cat Diseases; Cats; Ear Canal; Ear Neoplasms; Retrospective Studies
PubMed: 36066435
DOI: 10.1177/1098612X221119144 -
Journal of Veterinary Internal Medicine 2023Treatments currently available for ceruminous gland tumors include surgery and radiation therapy, which come with high financial costs and frequent complication and...
BACKGROUND
Treatments currently available for ceruminous gland tumors include surgery and radiation therapy, which come with high financial costs and frequent complication and recurrence rates.
HYPOTHESIS
To evaluate the treatment, response, complication, and recurrence of ceruminous gland tumors confirmed with biopsy and ablated using CO laser.
METHODS
Retrospective review of medical records from Iowa State University and the University of Illinois between January 1, 2016 and December 31, 2021. Electronic medical records were evaluated for a histopathologically confirmed ceruminous gland tumor via video-otoscopic aided biopsy and subsequent CO laser ablation. Signalment, tumor type, size, location within the ear canal, length of time tumor was present before presentation, advanced imaging, and follow-up including recurrence were assessed.
RESULTS
Fourteen ceruminous gland adenomas (4 dogs, 10 cats) and 12 ceruminous gland adenocarcinomas (7 dogs, 5 cats) were identified. Bacterial otitis externa was present in 4/26 (15%) animals. Recurrence was identified in 1/14 (7%) ceruminous gland adenomas and 1/12 (8%) ceruminous gland adenocarcinomas.
CONCLUSIONS AND CLINICAL IMPORTANCE
Video-otoscopic aided biopsy and CO laser ablation of ceruminous gland tumors in dogs and cats is a viable treatment option with low recurrence and complication rates with CO laser ablation.
Topics: Humans; Cats; Dogs; Animals; Ear Canal; Carbon Dioxide; Retrospective Studies; Cat Diseases; Dog Diseases; Biopsy; Adenocarcinoma; Skin Neoplasms; Laser Therapy; Adenoma
PubMed: 37731239
DOI: 10.1111/jvim.16873 -
Indian Journal of Otolaryngology and... Dec 2022Pleomorphic adenoma originating from the external auditory canal is extremely rare, benign tumor. Ceruminal glands are modified sweat glands of the skin, present in the...
Pleomorphic adenoma originating from the external auditory canal is extremely rare, benign tumor. Ceruminal glands are modified sweat glands of the skin, present in the external auditory canal that may give rise to (a) benign tumors such as ceruminous adenoma, pleomorphic adenoma, and syringocystadenoma papilliferum, or (b) malignant tumors such as ceruminous adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma. We report a case where a 25-year-old woman presented with right aural swelling and otalgia since 1 year. A canal-filling aural mass was noted on clinical examination. Computed tomography imaging showed no intracranial extension or any association with the adjacent parotid gland. Subsequent excision biopsy and histologic examination revealed features suggestive of pleomorphic adenoma. Similar to the pleomorphic adenoma of salivary glands, recurrence or malignant degeneration with cellular atypia and metastasis can occur on rare occasions. Care must be taken to distinguish this from adenoid cystic carcinomas, ceruminous adenocarcinomas, and mucoepidermoid carcinomas.
PubMed: 36742482
DOI: 10.1007/s12070-021-02862-9 -
Journal of the American Veterinary... Dec 2019An 18-year-old domestic medium-hair cat (cat 1) and a 16-year-old domestic shorthair cat (cat 2) were evaluated because of obstructive skin lesions involving the...
CASE DESCRIPTION
An 18-year-old domestic medium-hair cat (cat 1) and a 16-year-old domestic shorthair cat (cat 2) were evaluated because of obstructive skin lesions involving the perimeter of the left external auditory canal.
CLINICAL FINDINGS
Otitis externa was present in affected ears secondary to obstructive soft tissue growths involving the outer margin of the external auditory canal and outer third of the vertical ear canal. Histologic examination of a preoperative biopsy sample revealed multiple ulcerated ceruminous gland adenomas in the affected ear of cat 1. Histologic examination of the submitted tissue from cat 2 confirmed ceruminous cystomatosis with surface colonization of yeast compatible with spp.
TREATMENT AND OUTCOME
Both cats underwent partial resection of the upper third of the affected vertical ear canal and associated diseased skin. The incised margin of the pinna was sutured to the margin of the remaining portion of the vertical ear canal with absorbable sutures. Both cats were disease free over a 12-month (cat 1) or 10-month (cat 2) follow-up period. Cat 1 later developed a small ceruminous gland adenocarcinoma in the adjacent rostrolateral margin of the vertical ear canal 1 year after surgery; the mass was resected, and the patient was free of recurrence 4 months later.
CLINICAL RELEVANCE
Partial resection was an effective alternative to complete vertical ear canal resection for lesions involving the upper third of the vertical ear canal in these cats; the partial resection procedure was deemed simpler to perform and less traumatic to the cat. Functional and cosmetic results were excellent, with preservation of the overall anatomy of the external auditory canal.
Topics: Animals; Cat Diseases; Cats; Ear Canal; Ear Neoplasms; Malassezia; Neoplasm Recurrence, Local; Otitis Externa
PubMed: 31793833
DOI: 10.2460/javma.255.12.1365 -
BMJ Case Reports May 2021
Topics: Adenocarcinoma; Humans; Neck; Nose; Pharynx
PubMed: 33958359
DOI: 10.1136/bcr-2020-241069 -
Ear, Nose, & Throat Journal May 2022External auditory canal cancer is a rare disease which can be treated by surgery or chemoradiation. The most common histological type is squamous cell carcinoma, but...
External auditory canal cancer is a rare disease which can be treated by surgery or chemoradiation. The most common histological type is squamous cell carcinoma, but rare types such as adenocarcinoma have been reported and are thought to be derived from the ceruminous glands. Here, we present a case of ceruminous adenocarcinoma, not otherwise specified (NOS) in the external auditory canal. A 72-year-old woman was referred to our department with discomfort due to a mass in the external ear canal. No typical symptoms of malignancy, such as pain or bleeding, were noted at the initial examination. The patient underwent a total excision under local anesthesia as a diagnostic treatment. She was diagnosed with ceruminous adenocarcinoma, NOS based on the results of immunostaining of the excised specimen, and is currently being followed up as an outpatient. Adenocarcinoma is thought to originate from the cerumen glands of the ear canal and the lack of specific symptoms may make it difficult to differentiate it from benign tumors. Although adenocarcinoma, NOS has been reported in the head and neck region, there have been no reported cases occurring in the external ear canal, and to the best of our knowledge, this is the first report.
Topics: Adenocarcinoma; Aged; Bone Neoplasms; Breast Neoplasms; Ear Canal; Ear Neoplasms; Female; Humans; Neoplasms, Connective Tissue; Sweat Gland Neoplasms
PubMed: 32862724
DOI: 10.1177/0145561320954128 -
Exploration of Targeted Anti-tumor... 2023Malignant tumors of the external auditory canal (EAC) are rare neoplasms that appear in the head and neck area. A common feature of these malignancies is their rarity,... (Review)
Review
Malignant tumors of the external auditory canal (EAC) are rare neoplasms that appear in the head and neck area. A common feature of these malignancies is their rarity, as well as their delayed diagnosis due to the appearance of non-specific symptoms that mimic various benign otologic conditions. The reported histological types of cancer of the external ear are: squamous cell carcinoma, basal cell carcinoma, malignant melanoma, Merkel cell carcinoma, angiosarcoma, adnexal carcinoma (including ceruminous adenocarcinoma and adenoid cystic carcinoma), and lymphoma (Lancet Oncol. 2005;6:411-20. doi: 10.1016/S1470-2045(05)70208-4). Several therapeutic interventions have been proposed, primarily orientated towards the cure of the patient, placing the surgical excision of the lesions at the tip of the spear. Subsequently and depending on the clinical stage and the pathological characteristics of the tumor, radiation, chemotherapy, a combination thereof, or some form of palliative treatment for particularly advanced cases, may be recommended. The aim of all the above-mentioned approaches is the complete resection of the mass with negative surgical margins along with lymph node dissection, the elimination of any residual disease or metastasis, and the improvement of survival. The anatomical complexity of the region will always remain a demanding challenge. Nevertheless, advances in the fields of ear microsurgery, imaging, radiation, molecular biology, and genomics have led to remarkable outcomes compared to the past, with a view to the patient's quality of life. Large, well-organized, and prospective studies with the participation of multiple centers in contrast to existing retrospective studies with a limited number of patients will help to establish universally accepted guidelines. The exploration of the molecular and genetic background of these cancers in conjunction with the search for new biomarkers and target molecules seems promising for providing upgraded and more personalized treatment modalities for the future.
PubMed: 37970205
DOI: 10.37349/etat.2023.00169 -
The Journal of International Advanced... Dec 2016The external auditory canal contains ceruminous glands, which are modified apocrine sweat glands, along with sebaceous glands. Tumors that originate from ceruminous...
The external auditory canal contains ceruminous glands, which are modified apocrine sweat glands, along with sebaceous glands. Tumors that originate from ceruminous glands are very rare; thus, the classification, clinical behavior, and management of these tumors remain debatable. Here we present a case of ceruminous adenocarcinoma arising from the external auditory canal. Although most authors advise more aggressive therapy, our patient was treated with local en bloc resection of the tumor followed by intensity modulated radiotherapy and had no recurrence for 3 years. We suggest that limited surgery with safe margins followed by radiotherapy is an alternative choice of treatment in selected patients with ceruminous adenocarcinoma. Further reports are required to support this outcome.
Topics: Adenocarcinoma; Cerumen; Ear Canal; Ear Neoplasms; Exocrine Glands; Humans; Male; Middle Aged
PubMed: 27487364
DOI: 10.5152/iao.2016.1249 -
Head and Neck Pathology Mar 2009Ceruminal gland carcinomas are rare neoplasms confined to the skin lining the cartilaginous part of the external auditory canal.
BACKGROUND
Ceruminal gland carcinomas are rare neoplasms confined to the skin lining the cartilaginous part of the external auditory canal.
DESIGN
Retrospective.
RESULTS
The patients included 11 men and 6 women, aged 33-82 years (mean, 59.5 years). Patients presented clinically with a mass of the outer half of the external auditory canal (n = 14), hearing changes (n = 5), drainage (n = 4), or paralysis of the facial nerve (n = 3). The polypoid masses ranged in size from 0.5 to 3 cm in greatest dimension (mean, 1.8 cm). Histologically, the tumors demonstrated a solid to cystic pattern, composed of an infiltrating glandular to cribriform arrangement of epithelial cells. Histologic features included a dual cell population (although not the dominant histology), increased cellularity, moderate to severe nuclear pleomorphism, irregular nucleoli, increased mitotic figures (mean, 3/10 HPF), including atypical forms, and tumor necrosis (n = 2). Tumors were divided into three types of adenocarcinoma based on pattern of growth and cell type (ceruminous, NOS [n = 12], adenoid cystic [n = 4], mucoepidermoid [n = 1]). CK7 and CD117 highlighted the luminal cells, while S1-00 protein showed a predilection for the basal cells of ceruminous and adenoid cystic carcinomas. Metastatic adenocarcinoma or direct extension from salivary gland neoplasms are the principle differential considerations. Surgical resection was used in all patients with radiation used in four patients. Eleven patients were alive or had died of unrelated causes without evidence of disease (mean, 11.2 years); six patients had died with disease (mean, 4.9 years), all of whom had developed local recurrence.
CONCLUSION
Ceruminous-type carcinomas, with the exception of ceruminous mucoepidermoid carcinoma, all demonstrated a dual cell population of basal myoepithelial-type cells and luminal apocrine cells. The specific histologic sub-type does not influence the long-term patient outcome.
Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma; Disease-Free Survival; Ear Neoplasms; Ear, External; Female; Humans; Immunohistochemistry; Male; Middle Aged; Otorhinolaryngologic Surgical Procedures; Radiotherapy; Retrospective Studies
PubMed: 20596983
DOI: 10.1007/s12105-008-0095-9