TP53 mutation may underlie increasing incidence of external auditory canal carcinoma

Abstract

BACKGROUND: Primary neoplasm of the external auditory canal has historically been documented to have a low incidence rate of between one and six per million internationally, with UK incidence yet to be officially cited. METHODS: Here, we report a rise in incidence at a single UK trust with seven carcinomas (six T4 external auditory canal squamous cell and one T4 basal cell) reported within an 18-month period. All tumours underwent next generation sequencing. RESULTS: The cases recorded represented a twofold rise in incidence in reference to international literature from a population-adjusted estimate of 0.5-3 cases for the catchment area to seven cases. All cases were treated with temporal bone resections (n = 7) and with post-operative radiotherapy in six cases. Tumour analysis showed all were TP53 mutant and human papilloma virus (HPV)/P16 negative. CONCLUSION: We suggest chronic inflammation and genetic alterations as putative contributory factors in our case series and outline clinical strategies for timely detection of external auditory canal neoplasms.