Case Report: 56-year-old Woman Presenting with Progressive Hearing Loss, Chronic Otitis Media and Pulsatile Tinnitus
Introduction: Glomus tumors are rare benign lesions of the middle ear that are often associated with symptoms of progressive hearing loss and pulsatile tinnitus. Diagnosis is often delayed due to the slow growth of the tumor, and surgical resections of the mass are the mainstay treatment.
Case Presentation: A 56-year-old Latin American female was admitted to the hospital with a year-long history of intermittent pulsatile buzzing noise, progressive hearing loss, pain and discharge of the left ear. High-resolution Computerized Tomography and Magnetic Resonance Imaging revealed evidence of an enhancing mass lesion, which extended into the external auditory canal. A tympanomastoidectomy was performed. Most of the mass was removed, but some remained because of massive bleeding. The patient received 3 months of radiation therapy after the tympanic paraganglioma was surgically removed.
Conclusion: This case exposed the audiological findings, the location, and the extent of the tumor. Management options consist of radiation therapy and surgical management, depending on the size of the tumor. Early detection of glomus tumors is essential to prevent non-reversible complications.
Portero de la Torre M, Sánchez Gutiérrez R, Gallardo Muñoz I, Bravo Rodríguez FA. Paraganglioma timpánico con extensión a trompa de Eustaquio y nasofaringe: A propósito de un caso. Acta Otorrinolaringol Esp. 2012;63(4):314-317.
Boedeker CC, Ridder GJ, Schipper J. Paragangliomas of the head and neck: Diagnosis and treatment. Fam Cancer. 2005;4(1):55-9.
Hsu JL, Hwang CF, Kao YF, Lui CC, Lin JW, Peng JP. Paraganglioma presenting as chronic otitis media with cholesteatoma: pitfalls and strategies. Am J Otolaryngol. 2004 May-Jun;25(3):190-194.
Björklund P, Pacak K, Crona J. Precision medicine in pheochromocytoma and paraganglioma: current and future concepts. J Intern Med. 2016 Dec;280(6):559–73.
Kumar V, Abbas A, Aster J. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Elsevier; 2014.
Jethanamest D. Tympanic paraganglioma—Resection techniques. Oper Tech Otolayngol Head Neck Surg. 2016;27(1):15-19.
Hirunpat S, Riabroi K, Dechsukhum C, Atchariyasathian V, Tanomkiat W. Nasopharyngeal extension of glomus tympanicum: an unusual clinical and imaging manifestation. AJNR Am J Neuroradiol. 2006 Oct;27(9):1820–2.
Maurer CJ, Aschendorff A, Urbach H. Diagnosis of a tympanic paraganglioma with CT perfusion imaging: a technical note and case description. Neuroradiol J. 2017 Nov 24;197140091774457.
Lee JC, Malhotra A, Wang H, Westesson P-L. Paragangliomas of the Head and Neck: A Pictorial Essay. Univ Rochester Med Cent. 2007;1–25.
Kaylie DM, O'Malley M, Aulino JM, Jackson CG. Neurotologic surgery for glomus tumors. Otolaryngol Clin North Am. 2007 Jun;40(3):625-49.
Sennaroglu L, Sungur A. Histopathology of Paragangliomas. Otol Neurotol. 2002;23(1):104–5.
Carlson ML, Sweeney AD, Pelosi S, Wanna GB, Glasscock ME, Haynes DS. Glomus tympanicum: A review of 115 cases over 4 decades. Otolaryngol - Head Neck Surg (United States). 2015;152(1):136–42.
Sweeney AD, Carlson ML, Wanna GB, Bennett ML. Glomus tympanicum tumors. Otolaryngol Clin North Am. 2015;48(2):293–304.
Hu K, Persky MS. The multidisciplinary management of paragangliomas of the head and neck, Part 1. Oncology (Williston Park). 2003 Jul;01(7):3.
Rousseau A, Badoual C. Head and Neck: Paraganglioma: an overview. Atlas of Genetics and Cytogenetics in Oncology and Haematology. 2017;(5).
Offergeld C, Brase C, Yaremchuk S, Yaremchuk S, Mader I, Rischke HC, et al. Head and neck paragangliomas: clinical and molecular genetic classification. Clinics. 2012;67:19–28.
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