Mass in ear on touch bleeding heavily, cause is:
**Core Concept**
A mass in the ear that bleeds heavily upon touch is a clinical presentation suggestive of a vascular anomaly. The correct diagnosis is a vascular malformation or a vascular tumor, specifically a glomus jugulare tumor. These lesions are characterized by their rich vascular supply and potential for bleeding.
**Why the Correct Answer is Right**
The glomus jugulare tumor is a type of paraganglioma that arises from the jugular bulb. It is a highly vascularized tumor that can cause significant bleeding upon manipulation. The tumor's location near the jugular vein and carotid artery explains its rich vascular supply. The bleeding is often heavy and can lead to significant hemodynamic instability. The glomus jugulare tumor is typically diagnosed with imaging studies such as CT or MRI, which show a mass in the temporal bone with a rich vascular supply.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect as it does not specify a vascular anomaly, and a cold abscess would not typically bleed heavily upon touch.
**Option B:** This option is incorrect as a cholesteatoma is a type of skin cyst in the middle ear, and while it can cause bleeding, it is not typically associated with heavy bleeding upon touch.
**Option C:** This option is incorrect as a facial nerve schwannoma is a type of nerve tumor, and while it can cause facial weakness, it is not typically associated with heavy bleeding upon touch.
**Clinical Pearl / High-Yield Fact**
A key clinical pearl is that a mass in the ear that bleeds heavily upon touch is highly suggestive of a vascular anomaly, and imaging studies should be performed to evaluate for a glomus jugulare tumor or other vascular lesions.
**Correct Answer:** D.