Clinical characteristics analysis of adenoid cystic carcinoma of external auditory canal in advanced stages

SAI Na; LU Jinshan; ZHENG Qiuchen; HAN Weiju; WANG Guojian; SHEN Weidong

doi:10.3969/j.issn.1672-2922.2026.01.003

Abstract：Objective To report clinical outcomes of advanced external auditory canal adenoid cystic carcinoma(ACC),including causes of recurrence and management strategies.Methods Clinical data of 10 patients(4 males and 6 females)with ACC of the external auditory canal diagnosed at the General Hospital of the Chinese People's Liberation Army from January 2021 to December 2023 were retrospectively analyzed,including clinical manifestations,imaging characteristics,surgical strategies employed,postoperative follow-ups and outcomes.Results Disease duration ranged from 3 to 23 years.Initial clinical symptoms included earache(9 cases),external auditory canal mass(3 cases),hearing loss(3 cases)and otorrhea(2 cases).All cases had received local tumor resection at other hospitals.Based on the Pittsburgh classification,the lesion was T3 in 1 patient and T4 in 9.Four patients exhibited distant metastases,all in lungs.Six patients underwent subtotal or total temporal bone resection and subsequent radiotherapy and chemotherapy at local hospitals.The mean follow-up duration was(34.7±12.7)months,and the shortest recurrence time was 3 months.Nine patients survived with tumors,while 1 patient was tumor-free.Conclusions Local resection of external auditory canal tumor resulted in less favorable postoperative tumor control,with short-term local recurrence and poor prognosis.Both domestic and international guidelines for treating external auditory canal cancer state that the initial surgery is critical,emphasizing on complete or expanded tumor resection followed by radiotherapy and chemotherapy,supplemented when necessary with targeted therapy or immunotherapy to improve outcomes.