Case 80 - Discussion

Uploaded: 2007-11-30, Updated: 2007-12-01


Accessory tragus

  • Synonyms: rudimentary ear, supernumery pinna, wattle, accessory auricle anomaly, preauricular skin tag;

  • Accessory tragus is the most common congenital defect of the external ear. In the vast majority of cases it is an isolated developmental defect not associated with other abnormalities. It is  linked to maldevelopment of the first and second branchial arches.

  • Etiology: 1). isolated (non-syndromal); 2). Associated with 4p- syndrome (Wolf-Hirschhorn syndrome), Simpson-Golabi-Behmel syndrome or facio-auriculo-vertebral syndrome (Goldenhar syndrome);

  • Gross: often present in a pre-auricular location, but may appear anywhere along the path to the corner of the mouth, or more rarely, over the sternocleidomastoid muscle;

  • Histology: a polypoid structure containing skin, hair, fibroadipose tissue and cartilage. It is otherwise unremarkable;

  • Differential diagnosis:  This lesion may be confused with a fibroepithelial polyp (acrochordon) or soft fibroma, but the anatomic location and the presence of vellus follicles and cartilage leads to the correct designation.