Glomus Tumor

Glomus tumors (glomus jugulare, glomus tympanicum, other). Glomus tumors arise from tissue that senses gases in the blood and are virtually always benign, non-cancerous. These glomus bodies are most commonly found in the jugular bulb, the top of the internal jugular vein, before it exits the skull base. They may also occur in the middle ear, in the mastoid, in the facial nerve, and in other locations. The more limited form of glomus tumors arise in the middle ear and are called glomus tympanicum.

A more extensive glomus tympanicum may grow into the mastoid bone and be called a glomus mastoideum. Surgical removal is the preferred management for both, but simple long term observation may be acceptable if the person is elderly or in poor health. Unmanaged, the tumors may slowly grow out of the ear canal, destroy hearing, cause ear canal bleeding, facial paralysis, or inner ear problem.

The more extensive forms of glomus tumors involve the jugular bulb, the nerves of swallowing, voice box functioning, facial movement, tongue movement, and shoulder elevation. More extensive tumors may grow into the brain cavity, along the internal carotid artery, the main artery to the brain, and into the neck. Unchecked, tumor growth may slowly disable the nerves and compromise lower brain function. Management of glomus jugulare tumors is usually by surgery, but radiation may sometimes be employed. Glomus tumors rarely secrete hormones which cause high blood pressure and may cause a severe form of rapid heart beat that can be fatal. Management of glomus tumors may require highly a specialized radiology procedure called embolization.

The embolization procedure inserts a catheter into the leg artery, slips it up through the body, and allows the interventional radiologist to find the main blood supply to the tumor. The radiologist delivers tiny particles through the catheter into the tumor, plugging up most of the tumor’s blood vessels. Embolization typically reduces blood loss during surgery, decreases the need for blood transfusions, and makes the surgery safer and more efficient.