Survival Outcomes of Patients with Mycosis Fungoides Involving the External Ear and Ear Canal

Objectives/Hypothesis Mycosis Fungoides (MF) is the most common subtype of cutaneous T‐cell lymphoma. Disease involvement of specific locations may be more significant than simply the symptoms associated with that site; it is possible that involvement of certain sites could be associated with poor prognosis. We aimed to evaluate the outcomes of patients with MF with documented involvement of the EAC and external ear. Study Design Retrospective analysis. Methods We retrospectively reviewed 40 patients with MF that were treated by otologists between 2012 and 2021. Results We report the largest series of patients with MF involving the external ear and EAC. Of the 40 patients included in this study, 17 presented with Mycosis Fungoides in the otologic region (MFO). Of these 17 MFO patients, 2/17 had involvement of the external ear only, 3/17 of the EAC only, 11/17 of both the external ear and EAC, and 1/17 of the periauricular skin. Of note, 11/14 (79%) patients presenting with EAC disease died compared to11/26 (42%) of patients without involvement. In addition, eight of the 13 (62%) patients with external ear involvement died compared to 14/27 (52%) of patients without involvement. Ear canal involvement was associated with a statistically significant shorter overall survival duration in patients with MF (p = 0.03). Furthermore, disease in the EAC was found to have a hazard ratio value of 2.565 (CI 1.102–5.970). Conclusions Involvement of the EAC by MF portends a poor prognosis. This finding highlights the need for a more in‐depth otologic evaluation of patients with MF. Level of Evidence 4 Laryngoscope, 133:1486–1491, 2023 This manuscript reports our retrospective review of 40 patients with mycosis fungoides, and it demonstrates a comparison in outcomes of patients with ear involvement with those without ear involvement. Overall survival was shorter when the ear canals were involved.