gms | German Medical Science

GMS Current Posters in Otorhinolaryngology - Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery (DGHNOKHC)

ISSN 1865-1038

Pancreatic adenocarcinoma mimicking an otitis externa

Poster Otologie

  • corresponding author Wouter Baetens - UZ Brussel, Jette, Belgium
  • Stijn Halewyck - UZ Brussel, Jette, Belgium
  • Annieta Goossens - UZ Brussel, Jette, Belgium
  • Leen Van Acker - UZ Brussel, Jette, Belgium
  • Frans Gordts - UZ Brussel, Jette, Belgium

GMS Curr Posters Otorhinolaryngol Head Neck Surg 2017;13:Doc184

doi: 10.3205/cpo001738, urn:nbn:de:0183-cpo0017387

Published: April 26, 2017

© 2017 Baetens et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Introduction: Metastases of the external auditory canal (EAC) are uncommon. Otitis externa (OE) is a common pathology, well known to medical practitioners. The typical symptoms are ear pain, otorrhea and sometimes hearing loss. An adenocarcinoma of the pancreas is a more rare pathology. The symptoms are jaundice, belly or back pain, nausea and vomiting, weight loss and poor appetite.

This case is unique since the diagnosis of a pancreatic adenocarcinoma was started by an ENT surgeon because of ear complaints.

Case report: A 52-years-old woman presented at the ENT department with ear pain. Physical examination showed a painful, swollen EAC. Otorrhea was never present. The ENT surgeon also noted icteric sclera and an obvious weight loss. Because of the long-term ingestion of paracetamol and the icteric sclera, a blood sample was taken, showing a strong hepatic impairment. Different masses at the level of the pancreas, liver, adrenal gland, lung, subcutis and bone were seen on a CT-scan. A biopsy of the EAC confirmed an adenocarcinoma emanating from the pancreas. Chemotherapy was started.

Discussion: Primary tumours of the EAC are more common than metastases in the EAC. Different types of metastases in the EAC are described: for instance from colon adenocarcinoma, small cell carcinoma of the lung. In all these cases, the primary tumour was already known before ear problems occured. To our knowledge, this is the first case report in which the diagnosis of a pancreatic adenocarcinoma is initiated by a symptomatology that mimics an OE.

Conclusion: Otitis externa is a common disease but in very exceptional cases it may be a signal of an underlying condition. This case report shows the importance of obtaining a good medical history and general physical examination.

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