# An Unusual Presentation of a Black Discoloration on the Tympanic Membrane of a 10-Year-Old Girl: A Case Report

## TL;DR

A 10-year-old girl presented with a rare black discoloration on her eardrum, highlighting the importance of careful evaluation for unusual symptoms.

## Contribution

This case report presents a rare and atypical presentation of tympanic membrane discoloration in a pediatric patient.

## Key findings

- The black discoloration was observed in the posterior superior quadrant of the tympanic membrane near the umbo.
- The patient had a complex diagnostic journey involving multiple specialists and diagnoses over several months.
- No clear cause was identified, emphasizing the need for thorough evaluation of unusual ear findings.

## Abstract

This case report details an unusual presentation of unilateral tympanic membrane discoloration in a 10-year-old girl. The mysterious black discoloration was explored by various medical specialties, revealing a complex diagnostic journey due to the lack of evidence for this specific finding. Initially, the patient consulted her primary care physician after inserting a graphite pencil into her left ear canal, but without associated symptoms, she was considered to have returned to her baseline. The abnormal discoloration on the left tympanic membrane was first observed 10 months later, following diagnoses of two episodes of otitis media, otitis externa, and a middle ear effusion over three separate visits. By this time, the patient had been seen by four different medical professionals. The lesion was described as “a blackish discoloration in the posterior superior quadrant of the unperforated tympanic membrane near the umbo.” This report underscores the need for thorough evaluation and consideration of atypical presentations when encountering unusual tympanic membrane discolorations.