Simultaneous recurrent multiple chemodectomas

We report a case of concomitant, recurrent carotid body tumor and recurrent bilateral glomus jugulare tumors, with extensive intrajugular-venous extension. The patient's family history confirms the previously reported familial occurrence of chemodectomas. The value of preoperative angiographich evaluation is emphasized in establishing a diagnosis and formulating a therapeutic approach. Recurrence of chemodectomas after appropriate therapy, although unusual, was present in all three previously treated sites in this patient.

Ceruminous gland adenocarcinoma: a light and electron microscopic study

Tumors of ceruminous gland origin in the external auditory canal are rare in man. A case is described in which such a tumor presented as an invasive vascular temporal bone neoplasm, mimicking a glomus jugulare tumor. Light and electron microscopic study of this tumor confirmed a diagnosis of ceruminous gland adenocarcinoma. Tumors of ceruminous gland origin appear to have a distinctive clinical behavior by virtue of their unique anatomical location in the external auditory canal. Our experience with this case establishes another clinical picture characterizing the histologic type of ceruminoma designated as a ceruminous gland adenocarcinoma. We feel that the generic term "ceruminoma," with its implied histologic subgroups, is useful to the clinician when he encounters a tumor arising from the modified sweat glands of the external auditory canal.

Glomus jugulare tumor

A review has been made of the current recommendations for treatment of glomus tumors involving the ear. Thirty cases treated in our clinic have been reviewed, comprised of 8 glomus tympanicum and 22 glomus jugulare tumors. We recommend surgical excision as primary treatment for glomus tympanicum tumors and high voltage radiotherapy as primary treatment for glomus jugulare tumors. Visible residual tumor following adequate radiotherapy may remain unchanged for many years. Some cases that do not show a response to high voltage radiation may be suitable for secondary radical surgical treatment. Fortunately, we have not yet encountered a case of glomus jugulare tumor with nonresponse to high voltage radiation in the doses recommended. Long term follow-up is important.

Bilateral chemodectoma in the neck

A 55-year-old man with bilateral cervical chemodectoma is reported. The differences between tumours of the carotid body and those of the glomus intravagale are described and a brief review of the investigation and management of such tumours is given.

Ectopic muscle in the middle ear

An ectopic muscle was found in the hypotympanum of a 31-year-old Japanese male. The muscle produced symptoms quite similar to those seen in cases of glomus jugulare tumor: a red mass visible through the ear drum, conductive deafness, a compressed jugular bulb demonstrable by retrograde jugulography, and VIIth and IXth nerve paresis. However, the audible pulsating tinnitus of glomus jugulare tumor was absent. The mass proved to be a muscle speculated as being a part of the levator veli palatini muscle. In view of our findings, ectopic muscle should be included in the differential diagnosis of glomus jugulare tumor.

Combined approach surgery for removal of glomus jugulare tumors

The ideal surgical treatment for glomus jugulare tumors is total removal. Efforts have been made periodically to accomplish this since shortly after this tumor was first identified in the early 1940's. This paper describes a method of removal using a combined approach through the neck and temporal bone, preceded by a course of preoperative irradiation therapy. The early results that have been obtained using this procedure in 10 patients are reported.

The jugular bulb: its anatomic and clinical considerations in contemporary otology

Advances in neurotologic diagnosis and surgery has pointed to the need for a complete reassessment of the relationship and significance of the jugular bulb and sigmoid sinus is discussed and selected temporal bone sections presented to illustrate the varying locations of the jugualr bulb. Considerations in differential diagnosis are presented and examples of surgical procedures are discussed wherein the jugular bulb was encountered and the methods of management are detailed in these instances.

Aneurysms of the petrous portion of the internal carotid artery

Aneurysms of the petrous portion of the internal carotid artery are rare lesions. One case is reported here and 18 others have been found in the literature. These lesions usually arise in young men who present with auditory dysfunction. The aneurysm is usually discovered as a pulsating purple mass in the middle ear and mistaken for a glomus jugulare tumor. A definitive diagnosis can be made by carotid angiography. Subtraction techniques are very helpful. Carotid ligation or trapping is the treatment of choice.

Radionuclide angiography in evaluation of chemodectomas of the jugular glomus

Clinical, radiographic, and radionuclide angiographic findings of three cases of jugular glomic tumor associated with hearing loss are discussed. In one case computed tomographic findings are discussed. It is concluded that radioisotopic techniques may be useful in diagnosis and follow-up of this tumor.

Glomus jugulare tumors of the middle ear and mastoid: diagnosis and surgical treatment

At the 1976 Southern Sectional Meeting of American Laryngological, Rhinological and Otological Society, Inc., a color movie presenting two cases on the "diagnosis and treatment of glomus jugulare tumors of the middle ear and mastoid" was shown. The purpose of this paper and film is to describe the author's experience of 16 cases of glomus tumors involving the middle ear and mastoid (seven tympanicum and nine jugulare). A review of the literature and findings pertaining specifically to the two cases shown in the film is presented.

Glomus jugulare tumor. Disseminated form in the central nervous system

We will describe a case of glomus jugulare tumor that illustrates the potential for multiple areas of metastasis throughout the central nervous system. Extension through the dura into the subarachnoid space allows seeding via the cerebrospinal fluid as far away as the cauda equina. We will review the usual clinical course of the tumor and will evaluate the symptoms relative to the location of extension. In this case, the symptoms related to increased intracranial pressure with brain stem compression, which progressed rapidly to cause the patient's death.

Schwannoma of the jugular foramen

Two cases of schwannoma limited to the jugular foramen are described. This entity may clinically and radiologically resemble glomus jugulare tumors so closely, that only careful histological examination of an adequate surgical tumor specimen can provide a definitive diagnosis. Since documentation of this form of neurogenic tumor is lacking in the literature, it suggests that the entity is very rare or that such tumors may be erroneously classified as glomus jugulare tumors. The two cases in this study were managed surgically by subtotal removal via a wide transmastoid approach.

Middle ear masses mimicking glomus tumors: radiographic and otoscopic recognition

A high jugular bulb, an ectopic carotid artery, and an intratympanic cholesterol granuloma may, at times, mimic a middle ear glomus tumor, otoscopically. The otoscopic and radiographic findings which differentiate these lesions include microscopic otoscopy, tomography, carotid arteriography, and retrograde jugular venography. Examples of otoscopic and radiographic findings and procedures which enable the clinician to differentiate these lesions are presented.

Glomus jugulare tumours

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