The therapeutic options for glomus tumor management are either palliative (ie, radiation, embolization or a combination) or definitive (ie, surgery or combinations of surgery-radiation, radiation-surgery or embolization-surgery). Of these, surgical excision is the standard treatment modality for glomus tympanicum tumors. As glomus tympanicum tumor has highly vascular nature, profuse hemorrhage may be intermittently induced during its removal. Preoperative embolization is used frequently to reduce intraoperative bleeding. We report a case of glomus tympanicum tumor which was removed completely with the help of direct inject of HistoacrylR into the mass during the operation. This method allows almost bloodless ablation of the entire tumor.
Enbucrilate ; Glomus Tumor ; Glomus Tympanicum Tumor* ; Glomus Tympanicum* ; Hemorrhage

OBJECTIVES: To present a case of type 1 glomus tympanicum, its clinical presentations, surgical management and outcome.
METHODS:
Design: Case Report
Setting: Tertiary Government Hospital
Patient: One
RESULTS: A 44-year-old woman with pulsatile tinnitus, vertigo, headache, ear fullness and decreased hearing on the right had a pulsatile reddish mass behind the tympanic membrane and Brown sign. Weber test lateralized to the right with mild conductive hearing loss on pure tone audiometry. Contrast CT scan demonstrated a 5x6 mm well-defined enhancing mass in the meso- and hypotympanum. Internal auditory canal MRI showed an avidly enhancing 5x3x4 mm nodule within the right middle ear adjacent to the cochlear promontory and anterior to the lateral semicircular canal. Impression was glomus tympanicum, type 1. The mass was excised via transcanal approach with post-operative resolution of tinnitus, headache, vertigo and improvement of hearing. Final histopathology was consistent with glomus tumor.
CONCLUSION: Glomus tympanicum tumors are rare, benign middle ear paragangliomas that arise from Jacobson's nerve are slow-growing and locally destructive. CT scan and MRI may detect involvement of other structures. Surgical resection is the primary treatment modality. Type 1 glomus tympanicum tumors are small and limited to the promontory and a less-invasive transcanal approach may be employed.

Human ; Female ; Adult ; Glomus Tympanicum Tumor ; Tympanic Membrane ; Hearing Loss, Conductive ; Glomus Tumor ; Ear, Middle ; Hearing Loss ; Ear Neoplasms ; Vertigo

Jugulotympanic paragangliomas (JTPs) known as glomus tumors, are neoplasms of variable invasiveness that arise from the paraganglia situated around the jugular bulb or middle ear. We now report a rare case of JTP in an 18-year-old male. Preoperative diagnoses through external auditory canal biopsy and radiologic examination both failed. Even using a frozen section, an informative finding was not obtained because mostly granulation tissue was present along with associated squeezing artifacts. On permanent histologic examination, small cell nests between many ectatic small vessels and fibrotic stroma were seen, and those cells were positive for CD56, synaptophysin and chromogranin. Because JTPs are rare and have rather different histologic findings - higher vascularity, smaller and less uniform tumor cells than other paragangliomas - they are easy to misdiagnose. However, remembering those differences may help the physician avoid missing JTPs.
Adolescent ; Artifacts ; Biopsy ; Ear Canal ; Ear, Middle ; Frozen Sections ; Glomus Jugulare ; Glomus Tumor ; Glomus Tympanicum ; Granulation Tissue ; Humans ; Male ; Paraganglioma ; Paraganglioma, Extra-Adrenal ; Synaptophysin

Jugulotympanic paragangliomas (JTPs) known as glomus tumors, are neoplasms of variable invasiveness that arise from the paraganglia situated around the jugular bulb or middle ear. We now report a rare case of JTP in an 18-year-old male. Preoperative diagnoses through external auditory canal biopsy and radiologic examination both failed. Even using a frozen section, an informative finding was not obtained because mostly granulation tissue was present along with associated squeezing artifacts. On permanent histologic examination, small cell nests between many ectatic small vessels and fibrotic stroma were seen, and those cells were positive for CD56, synaptophysin and chromogranin. Because JTPs are rare and have rather different histologic findings - higher vascularity, smaller and less uniform tumor cells than other paragangliomas - they are easy to misdiagnose. However, remembering those differences may help the physician avoid missing JTPs.
Adolescent ; Artifacts ; Biopsy ; Ear Canal ; Ear, Middle ; Frozen Sections ; Glomus Jugulare ; Glomus Tumor ; Glomus Tympanicum ; Granulation Tissue ; Humans ; Male ; Paraganglioma ; Paraganglioma, Extra-Adrenal ; Synaptophysin