A Case of Pyogenic Granuloma in the Middle Section Ear: An Uncommon Clinical Entity

Pyogenic Granuloma (PG) is a benign vascular lesion that typically appears following trauma or irritation. It may also develop in individuals with immunosuppression or as a result of other unclear mechanisms that encourage angiogenesis and vasculogenesis. It is also known as lobular capillary hemangioma, as the endothelial cells are arranged in a characteristic pattern of circumscribed capillaries positioned in lobules. About one-third of PGs are found in the head and neck region, although they are rarely seen in the middle ear. Hereby, the authors present a case of a 60-year-old female patient who presented with ear pain and ear discharge in the right ear. She had a history of a right-sided modified radical mastoidectomy performed six months prior, which was aborted intraoperatively due to profuse bleeding. The histopathological report from that surgery was suggestive of a symplastic glomus tumour. Authors excised the middle ear mass in toto with subtotal petrosectomy, considering the diagnosis of a symplastic glomus tumour, and to authors surprise, the subsequent histopathological report suggested a PG of the middle ear cavity. Hence, the present case highlights the importance of considering PG in the differential diagnosis for previously operated patients with a history of blood-tinged ear discharge and otalgia.