The most common paragangliomas in the head and neck are carotid body, glomus jugulare, glomus tympanicum, and glomus vagale tumors. Imaging of head and neck glomus tumors paragangliomas. They originate from paraganglionic tissues that can be found in the adventitia of the dome of the jugular bulb. Available formats pdf please select a format to send. A reddish mass was observed through her tympanic membrane. The authors present a case of a successful preoperative embolization of a glomus jugulare. Ct cinematic rendering for glomus jugulare tumor with intracranial extension the development of multislice computed tomography ct scanners able to acquire highresolution isotropic volumetric. Complications in the management of large glomus jugulare tumours. The incidence of glomus jugulare tumor has been cited as 1 per 1. The authors have provided an elegant description with instructive schematic drawings of this complex cranial base approach. Imaging is the primary investigative modality for glomus tumors of the head and neck paragangliomas.
Cuetter 1 department of neurology, texas tech university health sciences center, paul l. Diagnosis, classification, and management of large lesions. A glomus jugulare tumor was diagnosed as per the initial clinical features. Growth rate analysis of an untreated glomus vagale on mri. Complete surgical extirpation is advocated for childhood glomus tumors. Although histologically benign, these tumors are locally destructive because. Pdf glomus tympanicum tumora rare presentation in a. The glomus tumor is a hamartoma which is morphologically comprised of endothelial lined vascular spaces the canal of sucquethoyer surrounded by epithelioid cells, called glomus cells. Leave the tumour and be monitored yearly, surgery, or radiotherapy. Altschul takes to twitter for world stroke day chat.
They are usually benign, meaning cells in the tumor are unlikely to spread to other parts of the body. Approaching lesions in this area requires extensive anatomical knowledge and experience, due to the many critical neurovascular structures passing through or around the jugular foramen. Jan 28, 20 glomus jugulare tumors are included in a group of tumors called paragangliomas. A rare case of glomus jugulare tumor presenting as. Both commonly present as a middle ear mass resulting in tinnitus in 80% and hearing loss in 60%. Glomus jugulare tumors are rare, slowgrowing, hypervascular tumors that arise within the jugular foramen of the temporal bone. Treatment of head and neck paragangliomas moffitt cancer center. They are included in a group of tumors referred to as paragangliomas, which occur at various sites and include carotid body, glomus vagale, and glomus tympanicum tumors. Onyx liquid embolic system les embolization of highly vascular lesions is becoming more frequently used as an adjuvant therapy prior to surgical resection. Pdf on apr 1, 2007, rs bhadauria and others published a case of secretory glomus jugulare find, read and cite all the research you need on researchgate. Letter to the editor hoarseness as presenting complain. We present a case of the transcanal endoscopic resection of a glomus tympanicum tumor. The term glomus jugulare tumor or nonchromaffin paraganglioma of glomus jugulare.
The abundant and excellent illustrations seemed more compatible with meningeal sarcomatosis. Pdf the goal of this paper is to analyze the extension and relationships of. Glomus tumors are rare, benign, but debilitating lesions which constitute between 1 and 5% of all tumors found in the hand. Glomus tumors are benign, slowgrowing tumors that include cervical and temporal bone jugulotympanic paragangliomas. In our experience, glomus tumors profoundly affect quality of life disability, crps and, in the published literature, can result in unnecessary surgery see patient 1 from sawada et al 1995. Hypertension and catecholamine biosynthesis associated with a. Fourteen patients with glomus jugulare tumors gjt were treated with stereotactic linear accelerator.
A combination of contrastenhanced computed tomography ct scanning, magnetic resonance imaging mri, and angiography is ideal for proper diagnosis and localization of the tumors. It has 1 compartments from front to back that contain the inferior petrous sinus, the cranial nerves ix, x, xi, and the sigmoid sinus which becomes the internal jugular vein, respectively. Intracranial involvement is noted in onethird of these lesions. A small glomus tympanicum tumor resected by minimally. Glomus jugulare tumors neurosurgery oxford academic. Glomus jugulare presenting with isolated facial nerve.
Glomus body tumors, often abbreviated as glomus tumors, are also known as paragangliomas or chemodectomas. Radiological features of glomus tympanicum and glomus jugulare. Approaching lesions in this area requires extensive anatomical knowledge and experience, due to the many critical. Glomus tympanicum tumor is a benign but most common tumour of the middle ear with relatively good prognosis if detected early. They are included in a group of tumors referred to as paragangliomas, which occur at various sites and include carotid body, glomus vagale, and glomus. The area of the skull affected by this type of tumor is called the jugular foramen. A 51yearold woman presented with pulsatile tinnitus of the right ear persisting for 6 months. The method is well suited for the management of patients with gjt.
We report a case of secretory glomus jugulare tumor in a 65 year old female who presented with hearing impairment, pulsatile tinnitus, from 3 years and difficulty in swallowing, hoarseness of voice and palpitation from last six months. Glomus tumors can cause considerable morbidity and screening efforts should be established. A glomus jugulare tumor develops when cells in nerves near the temporal bone of the skull begin to rapidly increase in number, forming a mass. We report a case of secretory glomus jugulare tumor in a 65 year old female who presented with hearing. Treatment of recurrent and residual glomus jugulare tumors. The 3 perpendicular dimensions in the anteroposterior, mediolateral, and craniocaudal directions were used to. Disseminated form in the central nervous system, i was skeptical that it was a glomus tumor. Glomus tumors of the fingers and toes associated with nf1 2. Dear editor, glomus tumors were described by rosenwasser in 1945 1.
Symptoms of these tumors usually include pulsatile tinnitus, hearing loss, facial nerve paralysis, vertigo, otalgia, dysphagia, hoarseness, throat sore, episodic hypertension with headaches, and tachycardia. Glomus tumors in children may be hidden by otitis media and appear more likely to be endocrine active. Symptoms of these tumors usually include pulsatile tinnitus. Shapiro s, kellermeyer b, ramadan j, jones g, wiseman b, cassis a. Microsurgical resection of glomus jugulare tumors with. Clinical study glomus jugulare presenting with isolated. Otogenic pasteurella multocida brain abscess and glomus jugulare tumour lan r. Paragangliomas are slow growing, hypervascular neuroendocrine tumors that develop in the extraadrenal paraganglion tissues. There are no early symptoms but eventually neural deficits appear as cranial nerves vii, viii, ix, x, and xii become involved. Clinical study glomus jugulare presenting with isolated facial nerve palsy angelicaa. The senior author jkl states that he has used this approach to treat 129 jugular foramen tumors, 30 of which were glomus jugulare tumors. Cuetter 1 department of neurology, texas tech university health. I have seen a consultant in my local hospital and he has given me three options. Pdf stereotactic radiosurgery for the treatment of glomus.
Metastases from glomus jugulare tumours request pdf. Failure to cure the lesion is apparent in five of six case reports of children with glomus jugulare tumors. The authors present a case of a successful preoperative embolization of a glomus jugulare tumor using onyx les. Longterm tumor control following stereotactic radiosurgery for jugular paraganglioma using 3d volumetric segmentation. A computed tomography scan revealed a small mass in the mesotympanum. Pdf treatment of recurrent and residual glomus jugulare tumors. Effects of preoperative embolization on glomus jugulare tumors. D treatment of recurrent and residual glomus jugulare tumors. Diagnosis, management, and complications of glomus tumors of.
Sukzessives auftreten eines bilateralen glomuscaroticumund. Pdf residual and recurrent glomus jugulare tumors are rare but challenging. Altschul on twitter chat for world stroke day 2014 dr. Gross total resection can be performed in over 90% of patients. Radical radiotherapy alone for glomus jugulare and tympanicum. Does, llc, for her substantive editing and extensive collaboration with us. Glomus jugulare tumors gjt are considered benign, slowgrowing and highly vascularized, and are also known as paragangliomas or chemodectomas.
Radical removal of glomus jugulare tumor can be achieved without. Paraganglioma involving the vagus nerve ganglia is termed glomus vagale. Abstract background limited data are available on the efficacy and impact on the quality of life qol of single. Glomus jugulare tumors are benign but locally aggressive tumors. A middle path in the surgical management of glomus. While it is a rare tumor, it is the most common of the jugular fossa tumors. Open letter from the editor jama otolaryngologyhead.
Stereotactic radiosurgery for the treatment of glomus. A glomus jugulare tumor is a tumor within the skull cavity. Frontiers microsurgical anatomy of the jugular foramen. She was diagnosed with a rightsided glomus tympanicum tumor. Response to letter to the editor outcomes of primary. Alfred ogden shares his expertise in resident anatomy lab dr. The authors were kind enough to send the actual tissue.
Hi i have recently been diagnosed with a glomus jugulare tumour, i am a 43yrs old female. Glomus tumors are rare and locally aggressive, vascular paragangliomas of the skull base. Altschul leads svin discussion on new stroke treatments dr. Symptoms of a glomus jugulare tumor include dizziness, difficulty swallowing, hearing issues, pain, or weakness in the muscles of the face. This manuscript accepted for publication january 8, 1977. This tumor gets its name from the nerves, called glomus bodies, and their location in a small opening in the temporal bone, known as the jugulare foramen. Glomus jugulare tumors, like pheochromocytomas, have been reported to synthesize and secrete norepinephrine and cause hypertension, but these tumors rarely secrete epinephrine. Radiological evaluation by mri and by ct showed a large expansile mass involving the left mastoid, jugular foramen, extending up to the left ica and indenting the left cerebellar hemisphere fig. Glomus tumors medigoo health medical tests medical. Treatment of recurrent and residual glomus jugulare tumors ncbi. Microsurgical resection of glomus jugulare tumors with facial nerve reconstruction. Among these categories, glomus jugulare tumor represents a.
Jugular paraganglioma rads iowa head and neck protocols. Glomus jugulare is a rare slow growing tumor that occurs within the jugular foramen of the temporal bone. Radical radiotherapy alone for glomus jugulare and. Median age at presentation was 55 years range, 2382. Although histologically benign, these tumors are locally destructive because of their proximity to the petrous bone, the lower cranial nerves, and the major vascular structures miller et al. The cranial nerves of the jugular foramen may be compressed, resulting swallowing difficulty, or ipsilateral weakness of the upper trapezius and sternocleiodomastoid muscles from compression of the spinal. Glomus jugulare tumors are rare tumors that are typically radiosensitive, highly vascular, and arise from the chief cells of the paraganglia in the adventitia of the dome of the jugular bulb. Given this fact, the reader should be cautioned that, of the 20 patients reported in the study, three of 20 had less than 2 years of followup, eight out of 20 had less than 3 years of follow. Glomus jugulare jugular foramen paraganglioma, temporal bone paraganglioma, glomus tumor is a slow growing vascular tumor located at the skull base. The management of glomus jugulare and tympanicum tumours is controversial due the long natural history and morbidity associated with intervention.
The radiosurgery is a safe and effective therapy for patients with glomus jugulare tumor. It is well recognized that glomus jugulare tumors are destructive, yet slow growing, tumors, and that growth may not be perceptible over only a few years. Alfred ogden shares expertise on minimally invasive spine surgery dr. The patient returned for scheduled operative resection one week later.
Objectiveto characterize clinical disease progression and radiologic growth in a series of observed, previously untreated, glomus jugulare tumors gjt. Letter to the editor hoarseness as presenting complain of a. Stereotactic radiosurgery for the treatment of glomus jugulare tumors article pdf available in surgical neurology international 4suppl 6. A rare case of glomus jugulare tumor presenting as papillede. Preoperative onyx embolization of glomus jugulare tumor. Outcomes of primary radiosurgery treatment of glomus jugulare tumors. Because of the anatomic location of glomus jugulare, this tumor typically involves the seventh, ninth, tenth, and eleventh cranial nerves. The jugular foramen remains one of the most complex regions of the human body.
Jun 14, 2017 glomus jugulare tumors are rare, slowgrowing, hypervascular tumors that arise within the jugular foramen of the temporal bone. Current perspectives in the management of glomus jugulare tumors. The four main locations of glomus tissue within the head and neck are. Glomus jugulare paraganglioma is a paraganglioma of the head and neck that is confined to the jugular fossa. Glomus jugulare are rare tumors which are locally aggressive with cranial, extracranial, and intracranial involvement. Among these categories, glomus jugulare tumor represents a particular and more rare kind of jugulotympanic lesion, often considered as surgically inaccessible for its possible intra and extracranial extension 11,12. Google scholar tran ba huy p, kania r, duet m, dessarddiana. Glomus jugulare is a rare slow growing tumor occurring within the jugular foramen that rarely presents with isolated symptoms.
The most frequent type of head and neck paraganglioma is the carotid body tumor, followed by the glomus jugulare and glomustympanicumtumors. Glomus jugulare are benign tumors that are slow growing, but locally aggressive. Response to letter to the editor outcomes of primary radios. Current perspectives in the management of glomus jugulare. Ct cinematic rendering for glomus jugulare tumor with. Response to letter to the editor outcomes of primary radiosurgery treatment of glomus jugulare tumorsare outcomes of radiosurgery for tympanojugular paragangliomas overestimated. Otogenic pasteurella multocida brain abscess and glomus. Despite the short followup period and the limited number of patients analyzed, we can infer that radiosurgery produce a tumor growth control with low morbidity, and may be used as a good option to surgical resection in selected cases. Oct 25, 2008 the glomus jugulare tumor arises from the dome of the jugular bulb or walls of the jugular fossa and grows much larger than the glomus tympanicus tumor. Diagnosis, management, and complications of glomus tumors.
Gjt is the most common neoplasm of the middle ear, and the second most common of the temporal bone. Glomus jugulare presenting with isolated facial nerve palsy. Angioinvasive nonchromaffin paraganglioma of the glomus. Glomus tumors are rare, benign tumors of the glomus body that cause severe paroxysmal pain secondary to changes in temperature or pressure.
1373 1433 1117 585 793 1207 769 1440 792 1356 939 1035 697 1131 1434 701 511 897 885 503 648 929 1349 1305 1061 1105 347 156 1384 667 934 318 496 428 1423 578 1443 1231 100 85 169 588 417 939