Poster Presentation The Annual Scientific Meeting of the Endocrine Society of Australia and the Society for Reproductive Biology 2014

Auricular Calcification: an unusual clue to an important endocrine disorder (#262)

Tien Lee 1 , Anthony Zimmermann 1
  1. Department of Endocrinology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia

Abstract

Calcification of the auricles that presents clinically with stiffened ears and moves as a single unit is rare1. It has been reported in patients with frostbite or trauma2, but has also been described in important endocrinopathies such as Addison's disease or hypopituitarism2,3,4. It could be the only important clue to the underlying endocrinopathy, which if missed, may have a fatal outcome.5 As a rare sign, it is often missed. In literature, it is generally discovered only when the patient presents acutely unwell with symptoms suggestive of adrenal insufficiency.

We report a unique case of hypopituitarism that was undiagnosed for over 30 years despite significant morbidity, in which investigations that resulted in the diagnosis were ordered following discovery of auricular calcification. This occurred in a 61 year old man who had to resign from work due to severe fatigue, presyncope and confusion. His hypopituitarism was only discovered recently after complaining about his stiffened outer ear. Clinically, he responded well to hormonal therapy for his central hypothyroidism, hypogonadotrophic hypogonadism, and secondary adrenal insufficiency.

We will discuss the case history and a provide a brief literature review.

  1. Mastronikolis NS, Zampakis P, Kalogeropoulou C, et al. Bilateral ossification of the auricles: an unusual entity and review of the literature. Head & face medicine 2009;5:17.
  2. Gordon DL. Calcification of Auricular Cartilage. Archives of Internal Medicine 1964;113:23.
  3. Randall RE, Spong FW. Calcification of the auricular cartilage in a patient with hypopituitarism. The New England journal of medicine 1963;269:1135–7.
  4. Barkan a, Glantz I. Calcification of auricular cartilages in patients with hypopituitarism. The Journal of clinical endocrinology and metabolism 1982;55:354–7
  5. Gogate Y, Gangadhar P, Walia RR, Banshali A. "Petrified ears" with idiopathic adult-onset pituitary insufficiency. Indian journal of endocrinology and metabolism. 2012 Sep;16(5):830-2.