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Reminder of important clinical lesson
Case report
Erosive rodent ulcer of the ear secondary to neglect
  1. Sarah Louise Gillanders1,2,
  2. Alison McHugh2,
  3. Justin Hintze1 and
  4. Martin Jude Donnelly2
  1. 1ENT, Royal College of Surgeons in Ireland, Dublin, Ireland
  2. 2ENT, Waterford University Hospital, Waterford, Ireland
  1. Correspondence to Dr Sarah Louise Gillanders; sarahlouisegillanders{at}rcsi.ie

Abstract

Basal cell carcinomas (BCCs) are slow-growing, locally invasive lesions that rarely metastasise, however, if left untreated can progress to extensive destruction of local structures giving rise to the alternative name ‘the rodent ulcer’. Here we present a case of BCC of the ear progressing to destruction of the pinna and mastoid, involving the facial nerve and breaching dura. This case presentation shows not only the seldom-seen natural progression of the rodent ulcer with impressive imaging and clinical photographs but also highlights a broader topic of capacity and consent in patients displaying maladaptive denial or abnormal illness behaviour, how this can affect patient outcomes and what we as clinicians can do to ensure the best care for our patients.

  • surgical oncology
  • otolaryngology / ENT
  • skin cancer

https://doi.org/10.1136/bcr-2020-234456

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    Footnotes

    • Contributors All authors included have contributed to the care of this patient and creation of this case report. SLG manuscript author, AMcH involved in original patient care and psychological input, advice and research on anosognosia with further editing on this section. JH instrumental in obtaining patient consent and advice with regards to paper structure and editing catering to BMJ case reports. MJD is the consultant overseeing the care of this patient and overall editor of this case report manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.