• Shreedhar Prasad Acharya, Chetana Pathak, Sandarva Giri, Meera Bista, and Deependra Mandal.
• Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal.
• JNMA J Nepal Med Assoc. 2020 May 30; 58 (225): 341-344.

AbstractThough squamous cell carcinoma is the commonest tumor, it rarely presents in the middle ear and follows a history of chronic ear discharge. Postauricular mastoid fistula is also a rare complication of chronic otitis media. These two pathological changes occurring simultaneously are even rarer. We report a rare case of a 37 years old male with a history of left-sided chronic ear discharge and conductive hearing loss. Squamous cell carcinoma along with postauricular mastoid fistula was diagnosed based on high-resolution computed tomography scan and histopathology. Left modified radical mastoidectomy with tympanic membrane grafting was done under general anesthesia. Often middle ear tumor is associated with long-standing ear discharge and this case is a very good example. The co-occurrence of the middle ear tumor with mastoid fistula is extremely rare as both the entities are rare in itself.

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