Aggressive papillary tumors of the middle ear constitute a small percent of adenomatous middle ear tumors. Patients usually present with long-lasting tinnitus, hearing loss, and vertigo and occasionally facial paralysis. Computed tomography findings predominantly suggest bone invasion. Thus, it is commonly misdiagnosed with chronic otitis media with a cholesteatoma. A 72-year-old man presented with chronic ear pain and ear drainage. The patient had a 63 decibels (dB) mixed-type hearing loss and a mass lesion at the temporal bone high resolution computed tomography. Explorative tympanotomy revealed a tumor with thick mucoid secretion and no bone erosion, for which an incisional biopsy revealed an adenoma. Radical modified mastoidectomy was performed and the definite pathology result was compatible with an aggressive papillary tumor. The patient was free of disease at six months of follow-up.Keywords: Ear neoplasm, mastoidectomy, middle ear, surgery.