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Evaluation of dogs and cats with tumors of the ear canal: 145 cases (1978-
1992)

Article  in  Journal of the American Veterinary Medical Association · June 1996

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Con tin
Evaluation of dogs and cats with tumors
iques in
of the ear canal: 145 cases (1978-1992)
:rs Co,

;our ley Cheryl A. London, DVM; Richard R. Dubilzeig, DVM; David M. Vail, DVM, MS;
1hia: JB Gregory K. Ogilvie, DVM; Kevin A. Hahn, DVM, PhD; William G. Brewer, DVM;
:dwith
Alan S. Hammer, DVM; Deborah A. O'Keefe, DVM, MS; Ruthanne Chun, DVM;
edlund Margaret C. McEntee, DVM; Dudley L. McCaw, DVM; Leslie E. Fox, DVM;
urgery. Alan M. Norris, DVM; JefferyS. Klausner, DVM, MS
'et Clin

Objective- To characterize the frequency, clinical

signs, biologic behavior, and response to treatment of
T umors of the ear canal in dogs and cats are rela-
tively uncommon, representing l to 2% of all tu-
mors in cats 1•2 and 2 to 6% of all tumors in dogs
Slatter tumors of the ear canal in dogs and cats. admitted for aural surgery. 3 Aural tumors in dogs have
ia:WB Design -Retrospective analysis of medical records. been described, although most reports are of tumors
Animals -Medical records of 81 dogs (48 malignant tu- in cats.1•4 · 7 Little is known regarding the prognosis for
tduced
t Surg
mors, 33 benign tumors) and 64 cats (56 malignant tu- dogs with tumors of the ear canal. Prognostic infor-
mors, 8 benign tumors). mation for cats with these tumors is available , but
te suc- Procedure -Data were analyzed for cats and dogs with much of it has been derived from clinical case reports.
ct in a malignant tumors, and risk factors were analyzed for their Furthermore, the response of dogs and cats with tu-
potential impact on survival time. mors of the ear canal to various treatments (eg, sur-
Jvable gery, radiotherapy, chemotherapy) is, to a large extent,
1 SAC
Results -Malignant tumor types most commonly re-
ported included ceruminous gland adenocarcinoma, unknown.
onasal squamous cell carcinoma, and carcinoma of undeter- The purpose of the study reported here was to
Rec mined origin. Median survival time of dogs with malig- objectively characterize the relative frequency , clinical
nant aural tumors was > 58 months, whereas that of signs, biologic behavior, and response to treatment of
P, eds. cats was 11.7 months. A poor prognosis was indicated benign and malignant tumors of the ear canal in dogs
i;352- by extensive tumor involvement (dogs) and by neurologic
signs at time of diagnosis, diagnosis of squamous cell
and cats. Furthermore, analysis for possible prognostic
carcinoma or carcinoma of undetermined origin, and in- indicators and survival analysis were undertaken.
vasion into lymphatics or blood vessels (cats).
Clinical Implications-Malignant tumors of the ear ca- Criteria for Selection of Cases
nal in dogs and cats have a propensity for local invasion, Detailed questionnaires regarding dogs and cats
but tend not to metastasize. Squamous cell carcinoma and with benign and malignant neoplasms were sent to
carcinoma of undetermined origin were the most locally participating Veterinary Cooperative Oncology Group
aggressive tumors. Malignant tumors of the ear canal are institutions. Dogs and cats with tumors of the pinna
best managed by aggressive surgical excision. Radiother- were excluded from the study. Criteria for inclusion
ne apy may be useful when tumors cannot be completely included submission of tumor tissues for diagnosis and
removed. (JAm Vet Med Assoc 1996;208:1413-1418) adequate records for analysis of signalment. Dogs and
cats that did not undergo treatment or for which sur-
edi- From the Department of Medical Sciences, School of Veterinary vival data was not available were not included in the
urb- Medicine, University of Wisconsin, Madison, WI 53706 (London ,
final survival analysis.
Dubilzeig, Vail); College of Veterinary Medicine and Biomedical Sci-
ences, Colorado State University, Fort Collins, CO 80523 (Ogilvie); Histologic examination-Tumor tissues were
leS
Department of Urban Practice, College of Veterinary Medicine,
of University of Tennessee, Knoxville, TN 37901 (Hahn); Department fixed in formalin , embedded in paraffin, sectioned,
ave of Small Animal Medicine and Surgery, College of Veterinary Med- stained with H&E, and reviewed by means of light
icine, Auburn University, AL 36849 (Brewer) ; Department of Clin- microscopy by a single pathologist (RRD) .
bu- ical Sciences, College of Veterinary Medicine, The Ohio State
University, Columbus, OH 43210 (Hammer); Department of Veter- Data evaluation-Records for each dog and cat
en inary Clinical Medicine, College of Veterinary Medicine, University were examined to provide data on risk factors, includ-
of Illinois, Urbana, IL 61801 (O'Keefe); Department of Veterinary ing age, body weight, breed, sex, duration of clinical
'llal Clinical Sciences, School of Veterinary Medicine, Purdue University, signs, previous treatment, tumor location, tumor size,
West Lafayette, IN 47907 (Chun); School of Veterinary Medicine,
North Carolina State University, Raleigh, NC 27606 (McEntee); De-
gross appearance of the tumor (including evidence of
lli- partment of Small Animal Medicine and Surgery, College of Veter- invasion), results of CBC, serum biochemical analysis ,
:on- inary Medicine, University of Missouri, Columbia, MO 65211 urinalysis, radiography of the skull and thorax , lymph
for (McCaw); Department of Small Animal Clinical Sciences, College of node status, evidence of concurrent disease , type of
Veterinary Medicine, University of Florida, Gainesville, FL 32610 biopsy performed, histopathologic diagnosis, evidence
IVM (Fox); Veterinary Referral Clinic of Mississauga, Mississauga, On- of paraneoplastic syndromes, type of treatment, stage
tario, Canada L4Z 1X8 (Norris); and the Department of Small
Animal Clinical Sciences, College of Veterinary Medicine, University
of tumor, survival time , necropsy results, and final dis-
of Minnesota, St Paul, MN 55108 (Klausner). Dr. London's present position. For dogs and cats with malignant tumors,
address is 7 Asheville Rd , Chestnut Hill, MA 02167. these factors were analyzed for their potential impact
Address reprint requests to Dr.Vail. on survival time. In most instances, disease-free inter-

996 JAVMA, Vol 208, No.9 , May 1, 1996 Scientific Reports Retrospective Study 1413
Table 1-Ciinical signs reported in dogs and cats with in domestic shorthair cats. Domestic longhair cats con- trean
benign and malignant tumors of the ear canal stituted 3 of 8 (38%) and 9 of 56 (16%) of the benign treati
Dogs Cats and malignant tumors in cats, respectively. Other
Benign Malignant Benign Malignant
breed predilections were not observed.
were
Clinical sign n ; 33 n; 48 n;8 n ; 56 Dogs with benign tumors of the ear canal com-
(10),
prised 16 females (5 sexually intact, 11 spayed) and
Existence of mass 20 (63) 36 (72) 4 (50) 26 (47) nant
Discharge 16 (50) 41 (82) 3 (38) 41 (75) 17 males (6 sexually intact, 11 neutered), whereas
(14),
Odor 8 (25) 17 (34) 0 101 13 (241 dogs with malignant tumors comprised 27 females (5
Pruritis 8 (25) 13 (26) 0 (0) 20 (36) lobul
sexually intact, 22 spayed) and 2l males (16 sexually
Signs of pain 6 (19) 13 (26) 0 101 7 (13) tum a
Neurologic signs* 0 101 6 (12.5) 2 (25) 13 (24) intact, 5 neutered). In cats, benign tumors were de-
broac
tected in 1 spayed female and 7 neutered males,
* Neurologic signs consisted of facial nerve paralysis, tilting of the head, and circling.
Numbers in parentheses are percentages. whereas malignant tumors were detected in 33 females
Nom
(4 sexually intact, 29 spayed) and 23 males (4 sexually
throt
intact, 19 neutered).
Table 2-Location of benign and malignant tumors of the visua
Age of dogs with benign tumors ranged from 4 to dogs
ear canal of dogs and cats 18 years (mean, 9.4 years; median, 9.3 years), com- 32 tl
Dogs Cats pared with 4 to 18 years (mean, 9.9 years; median, tend{
Benign Malignant Benign Malignant
10.0 years) for dogs with malignant tumors. Age of tilagE
Location n ; 33 n ; 48 n; 8 n ; 56 cats with benign tumors ranged from 0.5 to 15 years
mali!
Vertical canal 17 (52) 14 (29) 4 (50) 18 (32)
(mean, 6.9 years; median, 7.0 years), whereas age of (SJOk:
Horizontal canal 12 (36) 17 (35) 2 (25) 18 (32) cats with malignant tumors ranged from 3 to 20 years sive.
Bulla and ear canal 0 101 11 (23) 0 (0) 13 (27) (mean, 11.0 years; median, 11.0 years). tanec
Bulla alone 1 (30) 2 (4) 2 (25) 2 (4)
Right ear canal 20 (63) 18 (41) 2 125) 28 (50)
Body weight of dogs with benign tumors ranged
Left ear canal 12 (27) 26 (59) 6 (75) 28 (50) from 3 to 50 kg (mean, 20.8 kg; median, 18.7 kg),
whereas dogs with malignant tumors ranged from 4.8 in de
Numbers in parentheses are percentages.
to 38 kg (mean, 21.6 kg; median, 23 kg). Body weight sebac
of cats with benign tumors ranged from 2.7 to 9.0 kg cerw
vals were not different from survival times, because (mean, 5.0 kg; median, 4.8 kg), compared with 2.5 to l eac
most dogs and cats were euthanatized at the time of 7.7 kg (mean, 4.2 kg; median, 4.0 kg) for cats with brorr
tumor recurrence; thus, disease-free interval was not malignant tumors. tumc
examined in the final analysis. lorna
Univariate analysis to assess the prognostic value Clinical signs-The duration of clinical signs umir
of covariates was performed, using the Kaplan-Meier prior to presentation was 0 to 48 months (mean, 7.3 nom;
product limit method. 8 Differences in survival times months; median, 4.5 months) for dogs with benign tu- carci
between dogs and cats grouped according to the vari- mors, 0.5 to 96 months (mean, 7.8 months; median, 3 ligna
able being evaluated were estimated, using the gener- months) for dogs with malignant tumors, 0.1 to l2 ligna
alized Wilcoxon (Breslow) and generalized Savage months (mean, 3.5 months; median, 2 months) for aden
(Mantel-Cox) tests. Dogs and cats were excluded from cats with benign tumors, and 3 to 36 months (mean, nom:
analysis of survival time when they were not available 8.7 months; median, 4 months) for cats with malig- and!
for monitoring, when death was considered to be un- nant tumors. The distribution of clinical signs was re-
related to the neoplasm, or if follow-up was for < 1 corded (Table 1). Neurologic signs consisted of facial
nerve paralysis, tilting of the head, and circling. Lo- siste1
year. Probability values 0.05 were considered sig- of CJ
nificant. cation of tumors was recorded (Table 2); however, tu-
mor size could not be accurately determined from
Results most of the records. was
Medical records and tumor tissues of 165 dogs and tumc
cats were submitted. Dogs and cats with non-neoplas- Previous treatment-Sixteen of 33 (48%) dogs abno
tic lesions of the ear canal (15 animals), tumors of the with benign tumors had not received prior treatment, of tl
pinna (4), or that had medical records that did not 11 of 33 (33%) had received medical treatment de- servE
contain a histopathologic diagnosis (l) were excluded signed to alleviate signs of otitis, 3 (9%) had under- lymr:
from the study. After final review, medical records of gone surgical excision of the tumor, and 2 (6%) had Diag
81 dogs (48 malignant tumors, 33 benign tumors) and received medical and surgical treatment. Medical treat- taine
64 cats (56 malignant tumors, 8 benign tumors) were ment had been given to 19 of 48 (40%) dogs with in cis
deemed appropriate for further analysis. malignant aural tumors prior to referral, whereas 14 of cone
48 (29%) dogs had undergone prior surgical excision than
Signalment-Data on the signalment for dogs and of the tumors. Fifteen of 48 (31 %) dogs with malignant prep
cats included in the study were recorded. Cocker Span- tumors had not received treatment prior to referral. vent!
iels represented the largest proportion of the popula- Four of 8 (SO%) cats with benign tumors had previ-
tion of dogs with benign (9/33, 27%) and malignant ously received medical treatment. Of the 56 cats with
(8/48, 17%) tumors of the ear canal. Other breed malignant tumors, 31 (55%) had received prior med- raph
predilections were not detected. One half of the benign .ical treatment, 11 (20%) had undergone surgical ex- mali;
(4/8, 50%) and approximately two thirds of the malig- cision of their tumors, 11 (20%) had not received 3 ha
nant (37/56, 66%) ear canal tumors in cats were found treatment, 2 (4%) had received surgical and medical dise2

1414 Retrospective Study Scientific Reports JAVMA, Vol 208, No. 9, May 1, 1996 JAY},
ats con- treatment, and 1 (2%) had undergone photodynamic lytic lesion of the scapula. Radiography of the skull
benign treatment of the tumor. was performed on 27 of 48 (56%) dogs, revealing a
Other soft-tissue mass in the ear canal in ll dogs ( 41 %) , lysis
Appearance of tumors-Benign tumors in dogs of the bulla in l3 dogs ( 48%), and sclerosis of the bulla
1l com- were raised (18 tumors), pedunculated (17), irregular in 8 (30%) dogs. Of the 30 dogs in which the results
:d) and (10) , ulcerated (6) , or a combination of these. Malig- of lymph node examination were recorded, only 1 had
vhereas nant tumors in dogs were raised (20 tumors), ulcerated cytologic evidence of metastasis to the submandibular
tales (5 (14), or broad-based (11). Benign tumors in cats were lymph nodes at the time of tumor diagnosis. Paraneo-
exually lobulated (4 tumors) or raised (3), whereas malignant plastic syndromes were not detected. Three dogs had
ere de- tumors in cats were raised (27 tumors), ulcerated (22), concurrent primary tumors , including mast cell tumor
males, broad-based (14), or a combination of these. on the lateral portion of the thorax (1 dog), heman-
:emales Local invasiveness was assessed in all tumors. giopericytoma (1) , and squamous cell carcinoma on a
None of the benign tumors in dogs or cats invaded digit (1).
through the cartilage, as determined on the basis of
visual assessment. Invasiveness of malignant tumors of Cats with benign tumors-Of the 4 cats with be-
m 4 to
dogs was observed in 32 of 48 (67%) dogs. Of these nign tumors of the ear canal that had radiography of
, com-
32 tumors, 5 were limited to the epithelium, l2 ex- the skull, 3 had evidence of otitis media. Regional lym-
ledian,
tended into subcutaneous tissues, and 15 invaded car- phadenopathy was not evident in any of the cats. An
<\ge of
tilage. Visual assessment of tumor invasiveness of excisional biopsy was performed in 4 cats, and the 4
i years
malignant tumors in cats was recorded for 32 of 56 remaining cats with benign tumors underwent inci-
age of
(57%) cats, of which 28 were determined to be inva- sional biopsy. One cat had a positive result when
) years
sive. Of these 28 tumors, 9 had extended into subcu- tested for FeLV.
taneous tissues, and 19 had invaded through cartilage.
·anged Cats with malignant tumors-Radiography of the
7 kg), Histopathologic diagnosis-Benign aural tumors skull was performed in 27 of 56 ( 48%) cats with ma-
lm 4.8 in dogs consisted of polyp (8 tumors), papilloma (6), lignant tumors of the ear canal, revealing a mass in 11
11eight sebaceous gland adenoma (5) , basal cell tumor (5), ( 41 %) cats, lysis of the bulla in 5 (19%) cats, and scle-
1.0 kg ceruminous gland adenoma ( 4) , histiocytoma (2), and rosis of the bulla in 5 (19%) cats. Changes were not
2.5 to l each of plasmacytoma, benign melanoma , and fi- evident in 7 of 27 (26%) cats. Evidence of thoracic
; with broma. Benign tumors in cats consisted of polyp ( 4 metastasis was not detected in the 32 cats evaluated.
tumors), ceruminous gland adenoma (3) , and papil- Five of 56 (9%) cats had cytologic evidence of lymph
loma (1). Malignant tumors in dogs consisted of cer- node metastasis at the time of diagnosis ( 4 in the sub-
signs uminous gland adenocarcinoma (23 tumors) , carci- mandibular lymph nodes and 1 in the prescapular
11, 7.3 noma of undetermined origin (9), squamous cell lymph node). Paraneoplastic syndromes were not de-
tu- carcinoma (8) , round cell tumor (3), sarcoma (2) , ma- tected. Two cats had positive results when tested for
ian, 3 lignant melanoma (2), and hemangiosarcoma (l). Ma- FeL V, and 1 additional cat had a positive result when
to l2 lignant tumors in cats consisted of ceruminous gland tested for feline immunodeficiency virus. Concurrent
;) for adenocarcinoma (22 tumors), squamous cell carci- neoplasms were detected in 3 cats , including gastro-
nean, noma (20), carcinoma of undetermined origin (13) , intestinal lymphoma (1 cat), mammary gland adeno-
rralig- and sebaceous gland adenocarcinoma (l). carcinoma (1), and squamous cell carcinoma of the
lS re-
Clinical staging of disease-For all groups, con- inferior palpebra (l).
facial
. Lo- sistent abnormalities were not recognized in the results Treatment-Thirty-two of 33 (97%) dogs with
r, tu- of CBC , serum biochemical analysis, or urinalysis. benign tumors underwent surgical excision of their tu-
from Dogs with benign tumors-Thoracic radiography mor, and 1 did not receive treatment. Thirty-two of 48
was performed on l2 of 33 (36%) dogs with benign (67%) dogs with malignant tumors underwent surgical
tumors of the ear canal, but did not reveal consistent excision of their tumors, and 7 (15%) did not receive
dogs abnormalities. Six of 33 (18%) dogs had radiography treatment. Three of the dogs with malignant ear tu-
rrent, of the skulJ performed. Bulla involvement was ob- mors had surgery followed by a course of radiotherapy,
: de- served in 3 dogs. On the basis of palpation, regional 2 had radiotherapy alone, 2 received medical treatment
lder- lymph nodes were considered to be normal in all dogs. only, 1 received chemotherapy after surgical excision,
had Diagnosis was made by examination of specimens ob- and 1 received a combination of chemotherapy and
reat- tained by the use of excisional biopsy (31 tumors) or radiotherapy.
with incisional biopsy (2). Four dogs were admitted with Seven of the 8 cats with benign tumors underwent
,4 of concurrent tumors, including fibropapilloma on the surgical excision, and 1 cat did not receive treatment.
sion thoracic wall and perineum (2 dogs), carcinoma of the Thirty-one of 56 (55%) cats with malignant tumors
n.ant prepuce (l), and sebaceous gland carcinoma on the underwent surgical excision, and 16 (29%) were not
rral. ventral portion of the abdomen (1). treated because of the extent of disease. Radiotherapy
:evi- was administered after surgery in 4 cats, radiotherapy
.vith Dogs with malignant tumors-Thoracic radiog- alone was used in 3 cats , and chemotherapy was ad-
1ed- raphy was performed on 35 of 48 (73%) dogs with ministered after surgery in 2 cats. Radiotherapeutic
ex- malignant tumors of the ear canal. Of these 35 dogs, dosages and fractionation schemes that were used var-
ived 3 had radiographic evidence of metastatic pulmonary ied considerably between institutions , as did the choice
lical disease at the time of initial examination, and 1 had a of chemotherapeutic agents. This factor , combined

996 JAVMA, Vol 208, No.9 , May 1, 1996 Scientific Reports Retrospective Study 1415
 1.0 1.0 rep res
nign t
0.9-\ 0.9 signs '
a pro1
0.8- ---:
--
'·--- ... -- ... ----- .. ......... -- .......... -......... ---- -............ .
... 0.8 :
'·: rule , ;
0.7- 0.7 nign 1
i. (dural
0.6 0.6 i durati
0.5- 0.5 '·l .......................
,
mors
St
0.4 0.4
·--.-. -.. -,_---.--. ------. -.--.... -.. --. canal
! for m•
0.3 0.3 ically,
0.2 0.2 of the
····!............... .............................. was a
0.1 0. 1 associ
uminc
0.0,_--,---.--,.--.---.---.--.---.. standi
0 10 20 30 40 50 60 70 80 0 10 20 30 40 50
believ
of mal
Survival time (months) Survival time (months) mous
Figure 1-Graph of Kaplan-Meier estimate of cumulative Figure 2-Graph of Kaplan-Meier estimate of cumulative develc
survival times for dogs (n = 38) and cats (n = 40) with survival times for cats with various histologic types of tis mt
malignant tumors of the ear canal. ---- = dogs; - - - = malignant tumors of the ear canal. - - - = ceruminous betwe
cats. gland adenocarcinoma, n = 18; ···· = squamous cell car- ear ca
cinoma, n = 9; ---- = carcinoma of undetermined origin, report
n = 12.
with the low number of dogs and cats, precluded fur- wheth
ther discussion of the effectiveness of radiotherapy or wheth
chemotherapy. dian survival time greater than 49 months, which was develc
significantly (P = 0.05) different from cats with squa- natior
Survival analysis-Survival data were unavailable mous cell carcinoma or carcinoma of undetermined many
for 8 dogs, and 2 dogs were euthanatized at the time origin (median survival time, 3.8 and 5.7 months, re- evider
of diagnosis. Median survival time of the remaining 38 spectively; Fig 2). Cats with histologic evidence of in- possil:
dogs with malignant tumors was greater than 58 vasion had a median survival time of 4 months, in the
months (Fig l). Eight dogs were alive and did not have compared with 21.7 months for cats that did not have of the
evidence of recurrence of their tumor, 8 died from un- evidence of invasion (P < 0.02). A
related causes, and 8 died as a result of their tumor. did ql
The remaining 14 dogs were lost to follow-up moni- Discussion than :
toring at greater than 12 months and were censored Aural neoplasms in dogs have been reported in- gland
from the data. Only 3 dogs were necropsied, and 1 of frequently. 2·3·9·10 In 1 study of 46 dogs with tumors of camp;
these had evidence of local lymph node involvement the ear canal and pinna, 27 tumors were epithelial in noma.
and distant metastatic disease. Of the variables ana- origin, and 19 were of mesenchymal origin. 9 The latter carcin
lyzed, extensive tumor involvement, defined as in- were found most commonly at the base of the ear as sive n
volvement of the bulla as well as the ear canal, had a well as on the pinna. Additionally, in that study, Box- Altho;
substantial impact on survival time. Dogs with exten- ers were found to be predisposed to developing ear sues a
sive tumor involvement had a median survival time of tumors. In the study reported here, Boxers were not the de
5.3 months, whereas dogs with tumors confined to the overrepresented, and Cocker Spaniels represented the metas
vertical or horizontal ear canal had a median survival largest proportion of dogs with benign and malignant node
time of more than 30 months (P < 0.03). tumors . Because of the multi-institutional nature of the sion.
Survival data were not available for 11 cats, and study, relative proportions of breeds at risk were un- tumor
5 cats were euthanatized at the time of diagnosis. Me- available. As reported elsewhere, 2·3·9 predominantly locall1
dian survival time for the remaining 40 cats was 11.7 older dogs were found in the benign and malignant
months (Fig 1). The majority (26/40, 65%) of cats died groups. Although a predilection for the development of the
as a result of other causes, and only 4 were known to of aural tumors in male dogs has been reported, 9 a sex lr
be alive and free of aural tumors. Of the 5 cats that predisposition was not detected in our study. However, most'
were necropsied, 4 had noticeable localized extension it was interesting that more neutered males developed ily in
and recurrence of their tumors. Distant metastasis to benign tumors than did sexually intact males, and ongm
the lungs was observed in only 1 cat. Cats with neu- more sexually intact males developed malignant tu- middl
rologic signs at the time of diagnosis had a median mors than did neutered males. The importance of this times
survival time of 1.5 months, compared with 15.5 observation was unknown. dromt
months when neurologic signs were not evident (P < Surprisingly, ceruminous gland adenoma was not of cat
0 .009). Cats with a tumor histopathologically diag- the most common benign aural neoplasm in our study OamtT
nosed as ceruminous gland adenocarcinoma had a me- population. Polyps, papillomas, and basal-cell tumors report

1416 Retrospective Study Scientific Reports JAVMA, Vol 208, No.9, May 1, 1996 jAVM1
 represented the majority of benign tumors . Most be- counterparts 2 Because few benign aural tumors of cats
nign tumors did not involve the bulla , and neurologic were submitted for evaluation, definitive conclusions
signs were not detected. For dogs with benign tumors , cannot be made. However, there did appear to be a
a protracted ( 4.5 months) course of illness was the predisposition for benign tumors to develop in middle-
rule , and approximately a third of the dogs with be- aged , neutered male cats. Furthermore, Horner's syn-
nign tumors had a history of chronic otitis externa drome was recognized in 2 cats. Ceruminous gland
(duration of 9 months to several years). The median tumors in cats in our study were more likely to be
duration of clinical signs for dogs with malignant tu- malignant adenocarcinoma (22 tumors) than benign
mors (3 months) was slightly shorter. adenoma (3) .
Seventeen dogs with malignant tumors of the ear In the study reported here , ceruminous gland ad-
canal had a history of chronic otitis that had persisted enocarcinoma and squamous cell carcinoma developed
for more than 6 months prior to admission. Histolog- in a similar proportion of cats in our study population,
ically, several biopsy specimens had papillary dysplasia and a sex predilection was not apparent. This was in
of the ceruminous gland ducts. In some instances , this contrast to previous reports in which ceruminous
was associated with neoplasia , and in others , it was gland adenocarcinoma was observed to be the most
associated with inspissation and dilatation of the cer- common malignant tumor of the ear canal in cats , de-
--, uminous glands as a result of otitis externa. Long- veloping primarily in male cats. i.2· 14·15 Furthermore, al-
50
standing, localized inflammation (chronic otitis) is though squamous cell carcinoma of the external ear
believed to be an important factor in the development canal of cats has been described as being rare,2 several
of malignant tumors in human beings , especially squa- cases have been reported.5-7 · 15·19 Additionally , in a study
mous cell carcinoma. 11 •12 The proportion of people that in which l3 malignant aural tumors of cats were ex-
ulative develop tumors after having prior otitis externa or oti- amined, 6 were found to be squamous cell carcinoma,
Jes of tis media varies from 25 to 80%. 11-13 An association and the remaining tumors were ceruminous gland ad-
1inous between chronic otitis externa and neoplasms of the enocarcinoma.18 It is reasonable to expect that squa-
:lll car- ear canal in dogs has been reported. 2·3 In the study mous cell carcinoma might develop in the ear canal,
origin,
reported here, it was not possible to determine because squamous epithelium lines the auditory canal,
whether chronic otitis was secondary to the tumor or tympanic cavity, tympanic membranes , and membra-
whether the chronic inflammatory process led to the nous labyrinth.
h was development of the neoplasm. However , the combi- Metastasis in cats with malignant ear canal tumors
squa-
nation of histologic evidence of glandular dysplasia in at the time of admission was detected infrequently in
nined
many dogs , the clinical history of several dogs , and our study. Five cats had evidence of lymph node in-
s, re- evidence from studies in human beings suggests the volvement at the time of diagnosis , but none had evi-
o£ in- possibility that chronic inflammation does play a role dence of pulmonary metastasis. Subsequent metastasis
•nths,
in the development of benign and malignant tumors was observed in 5 cats in our study, 4 with metastasis
have of the ear canal. to regional lymph nodes and l with distant metastasis
As a group , dogs with malignant ear canal tumors to the lungs . Cats that died as a result of their tumors
did quite well, with a median survival time of more usually did so because of local recurrence or progres-
I
I than 58 months. Three of the 23 dogs with ceruminous sion of disease. This is in contrast to other reports in
d in- gland adenocarcinoma died as a result of their tumors , which metastasis to the local lymph nodes and lungs
rs of .l
compared with 4 of 8 dogs with squamous cell carci- had been described as a frequent sequela in cats with
al in ) noma. This was suggestive that aural squamous cell ear canal tumors , with approximately half of affected
atter carcinoma in dogs may be a more biologically aggres- cats having metastasis.2·8·15 It is possible that when lo-
ar as sive type of tumor than ceruminous gland carcinoma. calized control is improved, later metastatic events
Box- Although gross extension into the subcutaneous tis- may become more prevalent.
: ear sues and cartilage was evident in approximately half of In our study , malignant tumors in cats had a pro-
not the dogs with malignant tumors , few of these tumors pensity for extensive local involvement and invasion
I the metastasized, as evidenced by the low rate of lymph into surrounding tissues. Most tumors with visible ex-
nant node and pulmonary metastasis at the time of admis- tensive involvement and histologic evidence of inva-
f the sion. Thus, 'it appears that the majority of malignant sion were squamous cell carcinoma, indicating an
un- tumors of the ear canal in dogs have a propensity for aggressive biologic behavior. Histologic evidence of in-
ntly locally invasive behavior , but are unlikely to result in vasion was found to be an indicator of a poor prog-
1ant disseminated tumors , at least early in the development nosis for cats in our study. On the basis of the results
1ent of the tumors. of our study , most malignant tumors of the ear canal
sex Inflammatory polyps have been reported as the in cats have the propensity for locally invasive behav-
ver, most common aural tumor of cats , developing primar- ior, but are unlikely to metastasize early in the course
ped ily in young cats (3 months to 5 years old) 4 ·14-18 Polyps of disease.
and originate from the epithelial lining of the external or Detection of neurologic signs at the time of diag-
tu- middle ear canal, resulting in otitis media and some- nosis was an indicator of a poor prognosis for cats with
this times leading to the development of Horner's syn- malignant tumors in our study. A similar association
drome. Ceruminous gland adenoma of the ear canals has been observed in people with facial palsy at the
not of cats is believed to develop secondary to chronic in- time of diagnosis-' 1 Because clinical signs such as facial
ldy flammation. 2 Additionally, ceruminous gland adenoma nerve paralysis and Horner's syndrome may be an in-
ors reportedly develops more frequ ently than its malignant dication of advanced disease, it was reasonable to ex-

JAVMA , Vol 208 , No. 9 , May 1, 1996 Scientific Reports Retrospective Study 141 7
 pect that cats with neurologic signs may not have had rospective studies, including the study reported here ,
a favorable prognosis. Of 13 cats with neurologic signs, is the high number of dogs and cats unavailable for
9 had squamous cell carcinoma, which may reflect the follow-up monitoring. Although the medical records of
fact that this tumor originates in the middle ear. Fur- all accepted dogs and cats were used for characteriza-
thermore, cats with squamous cell carcinoma and car- tion of signalment, clinical signs, frequency of tumor
cinoma of undetermined origin had significantly types, and biologic behavior (metastatic rate) at the
shorter survival times, suggesting that these 2 histo- time of admission, survival analysis and the rate of
(
logic types of tumors behave in a more aggressive man- subsequent development of metastasis was limited. Ad-
ner than ceruminous gland adenocarcinoma. hering to strict censoring criteria for the use of Kaplan-
Overall, cats with malignant tumors of the exter- Meier survival analysis was important to minimize
nal ear canal had significantly (P < 0.03) shorter sur- bias. Another disadvantage of the study reported here,
vival times than did similarly affected dogs (Fig l). as well as other retrospective studies, was the small 01
fir
This concurred with reports that aural tumors in cats number of animals (3 dogs, 5 cats) that were necrop-
have a tendency to behave in an aggressive fashion. 2 sied. This could have resulted in an u.nderestimation an
Shorter survival times in cats may, to a degree, be a of distant metastases that developed subsequent to the
reflection of the fact that squamous cell carcinoma and time of initial diagnosis and treatment. Dt
carcinoma of undetermined origin develop more fre- AI
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Washin

1418 Retrospective Study Scientific Reports JAVMA, Vol 208 , No.9, May 1, 1996 JAVM

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