Simultaneous appearance of subcranial intrajugulare Glomus tumors and hemangioma

Introduction Complex subcranial tumors need an interdisciplinary approach for diagnosis and treatment. The imaging procedures with e.g. embolization are of outstanding importance.

Methods Presenting is a 64 year old female patient with suspicion of a Glomustumor. Primary symptoms was Tinnitus, a CT with suspicion of Glomustumor was made by the cardiologist who has seen some irregularities within the V. jugularis while doing a color duplex sonography. Doing a cMRI showed a jugularis Glomus tumor growing into the Foramen jugular and the mastoid. Before operating on the patient an embolization was planned, but in this case on this specific tumor it could not be performed. During operation, the jugular vein was removed caudally and then the tumor contained in the vein was traced into the base of the skull. In order to expose the jugular foramen, the nerve had to be relocated, which was complicated by an until then unknown hemangioma of the skull base. Only after removal of the hemangioma could the foramen be displayed and the nerve displaced. The vein was exposed to the bulb and the tumor completely removed.

Results Postoperative she had difficulties swallowing, furthermore she had a temporary paresis of the facial nerve, no signs of relapse.

Conclusion Only 0,6 % of all head and neck tumors are Glomus tumors. The finding of the tumor in the V. Jugularis is really rare and a combination with hemangioma not yet found in literature. Even though the preoperative diagnostic procedures had been very thorough the hemangioma was not seen. The operative treatment via excising the tumors stays the same even if both tumors present simultaneously.

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Publication History

Article published online:
10 June 2020