A Rare Case of Cutaneous Squamous Cell Carcinoma of the Ear

Introduction: Squamous cell carcinoma (SCC) is a common form of skin cancer that can arise on any cutaneous surface. It most often develops in areas of the skin that are chronically exposed to environmental risk factors, though it may also occur in less frequently exposed regions. This report presents a rare, and advanced case of cutaneous SCC of the ear and highlights the role of primary care physicians in prompt management. Family physicians play a critical role in patient counseling and education regarding timely intervention and management. This case report highlights the significant consequences of delays in treating otherwise manageable cancers. Result: A 69-year-old white male walked into a primary care office complaining of drainage and erosion of the left earlobe. The patient had not visited a primary care physician for over 13 years. The patient noticed a small growth in his ear approximately three months prior and did not address it. The skin lesion progressively worsened, resulting in drainage and erosionof almost half of his ear-lobe, prompting him to seek medical attention. The patient had a medical history of multiple basal cell carcinomas on his face that had been previously excised. Physical examination demonstrated erosion of the left auricle, with only a partial lobe remaining; associated with ulceration and purulent drainage. Erosion spread posteriorly into the mastoid skin area. This presentation raised a high suspicion of malignancy; and the patient was extensively counseled on the importance of prompt diagnosis and treatment adherence. An emergency specialist consultation was obtained, and a multi-disciplinary team approach was initiated. The patient underwent a wide excision, followed by pinna and ear canal reconstruction. He is currently receiving adjuvant chemotherapy and radiation along with close oncology follow-up. Conclusions: Cutaneous SCC can have variable clinical presentations including advanced staging at the initial visit. This report highlights the importance of coordinated care and close follow up of a rare presentations.