A 48-Year-Old Woman Comes to the Office Due to an Intermittent

A 48-year-old woman comes to the office due to an intermittent ear discharge over the last 2 years.  She has also noticed decreased hearing in the right ear recently.  Past medical history is significant for obesity, hyperlipidemia, seasonal allergies, and diet-controlled diabetes mellitus.  Otoscopy shows a small perforation in the right tympanic membrane and a pearly mass behind the membrane.  Conduction hearing loss is noted in the right ear.  The remainder of the ear, nose, and throat examination is normal.  Which of the following is the most likely cause of this patient's aural mass?

A) Cholesterol and lipid accumulation
B) Facial nerve neuroma
C) Malignant squamous cell neoplasm
D) Noncaseating granuloma
E) Squamous cell debris

Correct Answer:

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