2022, Number 4
Otic malakoplakia
Paz-Cordovéz A, Arteaga-Hernández E, Dueñas-Quispe J, Chamba-Camacho P
Full text
Language: Spanish
References: 10
Page: 277-282
PDF size: 304.19 Kb.
ABSTRACT
Background: Malacoplakia is a rare granulomatous disease of uncertain etiology that affects immunosuppressed individuals, it is related to inflammatory processes, generally bacterial, and appears to be a defect in the phagocytic function of histiocytes. Its diagnosis is histological and the treatment must combine surgical excision, antibiotic therapy and the limitation of immunosuppression.Clinical case: A 65-year-old male patient with diabetes that presented recurrent diffuse external otitis, the current episode did not subside with usual medication, on examination a granuloma was found on the posterior wall of the left external auditory canal. A sample was taken for culture of the exudate and excision of the granuloma was performed resulting in the presence of Pseudomonas aeruginosa and inflammatory polyp, respectively. The control showed a lesion in the external auditory canal, performing a tomography to rule out cholesteatoma; this showed an occupying lesion in the external auditory canal, middle ear and mastoid cells. A mastoidectomy was performed, finding a whitish, gelatinous-looking tumor sent to pathology where an inflammatory infiltrate with abundant CD68+ cells was evidenced. He presented a favorable evolution after treatment with ciprofloxacin 1 g IV for 14 days continuing OV for 4 months. Currently the patient is asymptomatic and with normal otological examination.
Conclusions: Malacoplakia at the otic level is exceptional; it can mimic neoplastic disease, so these entities must be ruled out. Its pathogenesis involves inflammatory processes. Despite its benign histology, it extends in continuity, so the treatment is surgical associated with antibiotics.
REFERENCES