A glomus jugulare tumor is a tumor in the skull. The area of the skull affected by this type of tumor is called the jugular foramen on the temporal bone. These tumors are nearly always benign (noncancerous), but their presence alone can cause hearing loss, problems with swallowing, and facial paralysis. Imaging tests can be used to confirm the presence of a glomus jugulare tumor; treatment involves surgical removal. After surgery, radiation therapy may be necessary to fully remove the tumor. Although the tumor is not likely to be cancerous, it is important to remove it in most patients because of the physical problems it can cause.
Glomus tumors are a group of tumors that develop in glomus cells and tissues. Glomus cells are specialized cells that are found in some blood vessels, as well as along nerves. They act to detect changes in the bloodstream, such as the presence of a certain chemical or a change in temperature. They can also respond to changes by releasing hormones.
Glomus tumors can form anywhere there are glomus cells. The jugular foramen region of the temporal bone in the skull contains many nerve bundles with glomus cells. Tumors that arise in this area are called glomus jugulare tumors. They form at the top of the jugular vein. This is the vein that takes blood from the brain back to the heart.
Glomus tumors, although not often cancerous, can grow extensively and may spread throughout the inside of nerves, along veins and arteries, and inside the ear and the Eustachian tube, which is the connection between the ear and the nose.
Because this type of tumor originates in the skull, just below the middle ear, symptoms related to the ear are common. These can include:
- hearing loss, partial or complete
- a ringing or pulsing sound
- ear pain
If the tumor is large enough and grows towards the face or neck, it can cause other symptoms when it compresses the associated nerves:
- weakness in facial muscles
- facial paralysis
- difficulty swallowing
- drooping shoulders
- tongue weakness
In a small percentage of glomus jugulare tumors, the mass may produce hormones and cause another set of symptoms:
- high blood pressure
- rapid heart rate
The causes of glomus jugulare tumor formation are not entirely understood, but genetic factors are suspected. These are thought to be acquired mutations that cause the tumors, rather than hereditary genes. This means that mutations causing the tumors are acquired during a person’s lifetime and are not passed on from one generation to the next.
Glomus jugulare tumors form more often in women than in men, and in the elderly. They can, however, form in anyone at any age.
A physical examination is the first step towards diagnosing a glomus jugulare tumor. The symptoms, as well as an examination of the ear and throat area, can indicate that a tumor may be present. There may be a lump on the neck, and the tumor may even be visible inside the ear.
To confirm the presence of a glomus jugulare tumor, a doctor needs to perform an imaging test, such as a computed tomography (CT) scan or magnetic resonance imaging (MRI). Either test can give a doctor a detailed image of the area in question and confirm or deny the presence of a tumor.
The only real treatment for a glomus jugulare tumor is surgery. Even if a tumor is small and not causing severe symptoms, it may need to be removed. If it is not removed, it will continue to grow slowly and cause more problems as it gets bigger. There are a few different options for surgery.
Complete Surgical Removal
Using traditional neurosurgical techniques, a glomus jugulare tumor may be completely removed. The process is difficult because there are so many nerves in the area, but if the tumor can be taken out without damaging any nerves, no other treatment is needed.
Stereotactic Radio Surgery
Not technically surgery, this type of treatment involves the use of X-rays aimed at the tumor to destroy the abnormal tissue. Unlike traditional radiation therapy, this technique is more targeted and less likely to harm normal tissue.
Surgery Followed by Radiation Therapy
In some cases, traditional surgery to remove most of the tumor is combined with follow-up radiation. The radiation targets the remains of the tumor that could not be physically removed by the surgeon.
The sooner the tumor is removed, the better the patient’s chances are at a full recovery. A smaller, less extensive tumor is easier to remove. When it has invaded blood vessels and nerves, it becomes more difficult to remove. In spite of the complex nature of surgery to remove this type of tumor, most people are cured following one or more procedures. In some cases, the tumor may return, which means that more surgery is required.