PMC3420451_01
Auxiliary examinations including (a) myringoscope which showed a flesh-colored mass in the anterior and inferior walls of deep right external auditory canal, near the tympanic membrane. (b) Axial cranial CT which presented a well-circumscribed soft tissue mass with homogeneous density (white arrow) in the right external auditory canal.
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fig1
Myringoscope revealed a mass in the deep right auditory canal near the tympanic membrane (Figure 1(a)). CT scan revealed a well-circumscribed, slightly enhanced solid mass in the inferior wall of the right external auditory canal without bony erosion (Figure 1(b)).
Pathological examination revealed (a) irregular cell trabeculae or clusters lying in lamina propria, without involving the epidermic layer (HE stain x100); (b) tumor cells which had a moderately differentiated appearance, containing pleomorphic nuclei with increased mitotic activity (HE stain x400).
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fig2
The cuticular layer was not involved (Figures 2(a) and 2(b)).
The tumor cells were strongly positive for cytokeratin (CK stain x100).
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fig3
The result revealed strongly positive for CK and NSE (Figures 3 and 4) and moderate positive for vimentin, showing a pattern consistent with a neuroendocrine tumor.
The tumor cells were strongly positive for NSE (NSE stain x100).
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fig4
The result revealed strongly positive for CK and NSE (Figures 3 and 4) and moderate positive for vimentin, showing a pattern consistent with a neuroendocrine tumor.