Glomus Tumours
What are Glomus Tumors?
Glomus tumors, also known as paragangliomas, are rare and typically benign neoplasms arising from the glomus bodies. The glomus bodies are specialised arteriovenous structures that regulate blood flow in response to changes in temperature and oxygen levels. These tumors commonly manifest in the head and neck region, especially in the temporal bone, inner ear region, or along the jugular vein.
Causes of Glomus Tumors
The exact cause of glomus tumors is not always clear, but genetic factors, such as mutation of the SDHD gene, may contribute to the development of these tumors.
Clinical Presentation of Glomus Tumors
The following are the clinical presentations of glomus tumors:
- Glomus tumours are highly vascularized, often leading to noticeable pulsation and a reddish or bluish hue of the overlying skin.
- A pulsatile mass, hearing loss, tinnitus, or a "bruit" (a humming sound) in the affected ear.
- In cases of temporal bone involvement, you may experience vertigo, facial weakness, or dysphagia.
Diagnosis of Glomus Tumors
Clinical evaluation, discussion of past medical history, and physical examination, including assessment of cranial nerves, are essential for initial evaluation. Further, your healthcare provider may order radiological imaging, such as contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT), which will help to identify the tumor's size, location, and vascular supply. Digital subtraction angiography (DSA) provides detailed information about the tumor's vascular anatomy, aiding in treatment planning. Audiometry and vestibular testing may also be ordered, especially when the tumor involves the temporal bone, to assess hearing loss and vestibular function.
Management of Glomus Tumors
The treatment of glomus tumors includes:
- Surgical Resection: Definitive treatment often involves surgical excision, with the goal of complete tumor removal while preserving vital structures.
- Radiation Therapy: Stereotactic radiosurgery or external beam radiation may be considered for non-surgical candidates or as an adjunct to surgery.
- Embolization: Preoperative embolisation may be performed to reduce vascularity, facilitating safer surgical resection.
- Medical Therapy: Symptomatic relief can be achieved with medications targeting associated symptoms, such as analgesics for pain management or anti-hypertensive agents for hypertension associated with these tumors.
Prognosis of Glomus Tumors
Most of the glomus tumors are benign; however, local invasion and recurrence can occur. Regular follow-up with imaging studies is crucial to monitor for recurrence or metastasis, especially in cases where complete surgical resection may not be achievable.
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