Acquired stenosis of external auditory canal secondary to paraneoplastic manifestation of renal cancer.

Male, 56, presenting with an ulceration on the right auricular concha for 45 days, with poor response to topical and systemic antibiotics, associated with otorrhea, hearing loss, otalgia and fever. Otoscopy revealed an ulcerated lesion in the auricle and edema of the EAC, preventing appropriate visibilization of the tympanic membrane. Computed tomography (CT) of the temporal bones (Fig. 1A) showed obliteration of the EAC without regional bone involvement. Due to the possibility of malignant external otitis, the patient was treated with Piperacillin and Tazobactam for 21 days. The lesion improved after two weeks, evolving to scar stenosis of the EAC. The patient was discharged after 21 days with antibiotic therapy (Ciprofloxacin 750 mg, 21 days) and office follow-up for possible surgery for stenosis correction. After 3 months, the patient presented with severe bilateral otalgia associated with otorrhea, and necrosis of the auricular concha, tragus and intertragic incisure