Management of a catecholamine-secreting tympanicum glomus tumour: case report.
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OBJECTIVE
To report the safe management and treatment of a catecholamine-secreting tympanicum glomus tumour.
METHODS
A 73-year-old women presented with a catecholamine-producing glomus tympanicum tumour, complaining of hearing impairment and left ear pain. Physical examination revealed a red, pulsating swelling in the left tympanic membrane. Computed tomography demonstrated a soft tissue mass filling the entire middle-ear cavity and a partial osteolytic lesion in the internal carotid artery. Angiographic examination revealed a densely contrasting tumour with feeding vessels from the ascending pharyngeal artery. Concentrations of serum noradrenalin and urine vanillylmandelic acid (VMA) were high. The tumour was completely resected using a potassium titanyl phosphate laser, the feeding vessels having been embolised the previous day. Concentrations of serum noradrenalin and urine VMA normalised following the operation.
CONCLUSIONS
Pre-operative embolisation is useful in the treatment of catecholamine-secreting tympanicum glomus tumours, not only for preventing a hypertensive crisis but also for reducing bleeding. The potassium titanyl phosphate laser is useful for complete resection of the tumour.
