A world recognized pattern is the tendency for albinos to suffer sunlight induced cancer. The head is held to be the commonest site. Therefore, one question arises as to how a double organ likes the ear fares. The simple answer is that one ear may be involved; later, the other could be affected. However, for the one ear to be attacked by a particular growth and the other ear to be involved by a different growth must be uncommon. Therefore, its occurrence is described in this paper with special reference to squamous cell carcinoma and basal cell carcinoma.

Keywords: Skin, Albino, Ear, Squamous cell carcinoma, Basal cell carcinoma, Nigeria

The skin is commonly the seat of sunlight induced cancer [1]. Another common finding is the selection of the head [2]. Therefore, what happens to the ears?

From Oman [3], a group reported on squamous cell carcinoma of the external auditory canal. From Tanzania [4], this type was the commonest histopathologic type in 75% of cases. In an African man from Guinea [5], who went to New York, his left leg showed squamous cell carcinoma in situ. Hence, could this earliest type be seen in the ear? In this context, we present an albino who had the squamous cell type in the one ear and the basal cell type in the other. This odd combination deserves documentation.

CASE REPORTS

1.     JO, a 45 year old man, an albino, attended the Orthopaedic Hospital, Enugu, on 17th August, 1984, with the complaint of chronic ulcer on the helix of the right ear. He was seen by Dr. Nwozo. This lesion was biopsied. It measured 2 cm across. On microscopy, individual cell keratinization with pearl formation was indicative of Squamous Cell Carcinoma.

2.     JO, the above man, returned on 14^th December, 1984 and was seen again by Dr. Nwozo. This time, there was a nodular lesion on the left helix of about 3 months duration. This was also biopsied. On microscopy, the growth showed malignant palisading of the basal cells unlike the previous biopsy. This indicated Basal Cell Carcinoma. 

DISCUSSION

Yakubu and Mabogunje, who worked in another part of Nigeria, concluded that “squamous cell carcinoma was the most common tumour type, in contrast to Caucasians, in whom basal cell carcinoma is most frequent [6]. From India, a 41 year old albino presented with multiple lesions including the one behind the right ear [7]. In the case of a Blantyre woman aged 27 years, the carcinoma was “a left-sided pre-auricular ulcerating mass” [8].

CONCLUSION

In conclusion, the ear may oddly be selected for cancerous attack in the albino. This is mostly due to the squamous cell variety, the basal cell form being rare. In this context, the present case is decidedly unique. Thus, the squamous celled lesion appeared earlier and was succeeded on the other side by a basal celled lesion.

1.       Yasumizu M, Nishigori C, Kawaguchi M, Takata T, Oiso N, et al. (2015) Malignant skin tumors in patients with oculocutaneous albinism. Pigment Disord 2: 218.

2.       Kiprono SK, Chaula BM, Beltraminelli H (2014) Histological review of skin cancers in African albinos: A 10 year retrospective review. BMC Cancer 14: 157.

3.       Furrukh M, Mufti T, Hamid RS, Qureshi A (2014) Squamous cell carcinoma of external auditory canal lacking epidermal growth factor receptor protein overexpression, in an elderly Omani with oculocutaneous albinism treated with palliative radiotherapy. BMJ Case Rep 2014: bcr2013203226.

4.       Mabula JB, Chalya PL, Mchembe MD, Jaka H, Giiti G, et al. (2012) Skin cancers among albinos at a University teaching hospital in Northwestern Tanzania: A retrospective review of 64 cases. BMC Dermatol 12: 5.

5.       Berger E, Hunt R, Tzu J, Patel R, Sanchez M (2011) Squamous-cell carcinoma in situ in a patient with oculocutaneous albinism. Dermatol Online J 17: 22.

6.       Yakubu A, Mabogunje OA (1993) Skin cancer in African albinos. J Acta Oncol 32: 1.

7.       Bhargava S, Kumar U, Rokde R (2018) Premalignant and malignant changes of skin in a patient with oculocutaneous albinism: Multiple actinic keratosis and squamous cell carcinoma. Int J Sci Rep 4: 40-43.

8.       Mapurisa G, Masamba L (2010) Locally advanced skin cancer in an albino, a treatment dilemma. Malawi Med J 22: 122-123.