Cystic Hidradenoma Presenting as a Chronic Aural Polyp: A Rare Ceruminous Gland Tumour of the External Auditory Canal

Cystic hidradenoma is a benign sweat gland tumor that very rarely arises in the external auditory canal and represents an uncommon subtype of ceruminous gland neoplasms.Owing to its low prevalence and nonspecific presentation, it is frequently misdiagnosed as chronic inflammatory ear disease, leading to delays in definitive diagnosis.We describe the case of a 32-year-old male who presented with several months of persistent unilateral otorrhea, aural fullness and conductive hearing loss refractory to multiple courses of topical and systemic therapy.Otoscopic examination demonstrated granulation tissue with a polypoid mass obstructing the external auditory canal, raising concern for chronic otitis externa, inflammatory aural polyp or neoplastic pathology.Computed tomography of the temporal bone showed a soft tissue lesion confined to the external auditory canal without bony erosion or middle ear involvement.Because symptoms persisted despite appropriate medical therapy, surgical excision was performed.Histopathologic evaluation revealed a benign cystic hidradenoma characterized by cystic architecture and adnexal differentiation without cytologic atypia or malignant features.The postoperative course was uncomplicated, with resolution of otorrhea, improvement in hearing and no evidence of recurrence at six-month follow-up.This case highlights the diagnostic challenge posed by rare ceruminous gland tumors and emphasizes the importance of early biopsy or excision in refractory unilateral external auditory canal disease, as surgical resection remains both diagnostic and definitive management.