A Massive Ear Canal Mass Resulting from an Embedded Arthropod

Objective: To describe a case of a massive ear mass obstructing the external auditory canal (EAC) attributed to an embedded arthropod, highlighting the diagnostic and therapeutic challenges posed by unusual etiologies of ear masses. Patients: The case was a 35-year-old female prisoner who presented with a 5 × 5.5 cm palpable exophytic mass obstructing the right EAC, accompanied by progressive hearing loss, bloody discharge, and persistent tinnitus. Interventions: Surgical excision of the infiltrating mass involving mastoidectomy and canaloplasty. Main Outcome Measures: Initial pathology suggested a pyogenic granuloma, but further analysis revealed a degenerating arthropod within reactive myofibroblastic and vascular changes. The patient was lost to follow-up despite a multidisciplinary treatment approach and primary surgical excision of the mass. Results: After surgical excision, the mass was confirmed as a florid reactive myofibroblastic and vascular mass enveloping a degenerating arthropod. The patient responded well to treatment without signs of infection or recurrence during follow-up. Conclusions: We report a case that emphasizes the importance of considering unusual etiologies for ear masses, especially in at-risk populations. It underscores the necessity for refined diagnostic and therapeutic strategies to manage similar clinical scenarios in the future.