Adenoid Cystic Carcinoma of the External Auditory Canal and Temporomandibular Joint - A Case Report

Rationale: Adenoid cystic carcinoma (AdCC) of external auditory canal (EAC) is a rare malignancy. It presents significant diagnostic and surgical challenges due to complex anatomy and functional implications. Patient Concerns: A 39-year-old female presented with progressive left ear pain, hearing loss and discharge, initially treated as otitis media. Diagnosis: Subsequent investigations confirmed AdCC of the EAC extending to the temporomandibular joint (TMJ). Treatment: The patient underwent wide local excision of the EAC AdCC lesion, including a superficial parotidectomy and partial TMJ tissue removal, guided by frozen section analysis. Final histopathology confirmed clear surgical margins across all 26 evaluated samples. Outcome: Post-operative recovery was uneventful with no residual disease or metastasis by 6 months. The patient reported mild trismus with preserved jaw function. Take-away Lessons: Early diagnosis and multidisciplinary management are critical for EAC AdCC with TMJ involvement. Meticulous surgical planning, clear resection margins and vigilant follow-up are crucial for optimal outcomes.