PMC4898170_01
50-year-old male with a glomus jugulotympanicum. Photograph of left ear with pink, glistening tumor extending through the left EAC and skin of the posterior auricular surface. Bulging of the intact skin by the underlying mass can also be noted.
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The mass also eroded through the mastoid sinus, skin, and posterior auricular sulcus, where the pink tumor could also be visualized by inspection (Fig. 1).
50-year-old male with a glomus jugulotympanicum. 3D volumetric reconstructed image obtained from a CTA after IV contrast administration correlates well with the physical findings demonstrated in Fig. 1 and also demonstrates the extensive vascular supply of the tumor, primarily from branches of the external carotid artery.
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Initially, CT angiography demonstrated a large, avidly enhancing vascular mass with extensive collateral vessels centered in the left middle ear extending through the EAC, pinna, and soft tissues of the periauricular region with evidence of skin erosion (Figure 2A, Figure 2B, Figure 2C).
50-year-old male with a glomus jugulotympanicum. Coronal CT angiogram. Reformatted image after contrast administration demonstrates enhancing mass centered in the left middle ear, extending intracranially to the middle cranial fossa. The tumor can also be seen surrounding the vertical segment of the left petrous internal carotid artery with extension into the left peri-auricular region.
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Multiple small flow voids were seen on MRI, giving the tumor the characteristic "salt and pepper" appearance and suggesting a glomus tumor (Figure 3A, Figure 3B, Figure 3C).
50-year-old male with a glomus jugulotympanicum. Axial CT images after administration of contrast with soft tissue algorithm demonstrated extensive bony erosion of the jugular bulb region with opacification of left mastoid sinus.
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Figure 4B). Feeder branches from the superficial and deep temporal arteries were embolized using 100- to 300-micron embolization spheres.