Glomus jugulotympanicum

Clinical:

  • A 41 years old man
  • Presented with left pulsatile tinnitus for 2 years
  • ¬†Associated with left ear blockage and reduced hearing
  • No history of ear discharge, no vertigo
  • Clinical examination showed reddish mass at left ear, pulsatile, medial to TM,
  • TM is intact. Right ear is normal.
HRCT temporal bone in axial plane
HRCT temporal bone in coronal plane
MRI brain axial T1+gadolinium

HRCT temporal bone and MRI findings:

  • soft tissue mass in the left jugular foramen with mild enhancement post contrast (red arrows)
  • erosion of left jugular foramen also seen (yellow arrows)
  • mass with similar signal intensity seen in the left middle ear, abutting the tympanic membrane
  • these two masses seems to be in continuity or represent same mass with extension to the region
  • left ossicles are normal
  • left mastoiditis seen
  • no intracranial extension, right ear is normal

Diagnosis: left glomus jugulotympanicum tumour

Discussion:

  • glomus jugulotympanicum is a glomus jugulare paraganglioma ¬†that has spread superiorly to involve the middle ear cavity
  • seen as mass in jugular foramen with permeative destructive changes along the superolateral margin of jugular foramen
  • CT is useful to assess bony margins of tumour which are typically showed erosion or moth-eaten appearance
  • CT also good to assess integrity of ossicles and bony labyrinth
  • MRI: Hypo hyper T1/T2 and intense enhancement. Salt pepper appearance from blood products

 

Author: radhianahassan