Head and Neck ImagingGlomus jugulare tumour
glomus tumour arising from the glomus bodies in the jugular foramen. These tumours may stay in the jugular foramen, but often extend to the middle ear cavity; when middle ear extension occurs, such a
tumour is called a jugulotympanic glomus
tumour. Glomus jugulare
tumour encroaches upon the adjacent cranial nerves and may cause paralysis of these nerves. Pulsatile
tinnitus is often present. When extending to the middle ear, it may cause
conductive hearing loss, and otoscopically a reddish mass is seen behind the inferior part of the ear drum.
CT findings are erosion and enlargement of the jugular fossa, and often also erosion of the floor of the middle ear. As the
tumour enlarges, the posteroinferior side of the petrous pyramid will become eroded, eventually involving the occipital bone, hypoglossal canal and foramen magnum. Extension into the posterior fossa occurs extradurally. Inferior extension along or within the internal jugular
vein may be seen. The extension of the soft tissue component of the
tumour can be better appreciated on
MRI (
Fig.1) Arteriography is not required for the diagnosis, and is reserved for embolization prior to surgical resection.
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Axial gadolinium-enhanced T1-weighted spin-echo images.
a. At the level of the right jugular foramen, soft tissue mass with intralesional signal voids (arrow). Extension into the middle ear cavity (arrowhead).
b. Just below the temporal bones, caudal extension into the carotid space is seen (arrows).
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Glomus jugulare tumour, Fig.1 (a) | | Glomus jugulare tumour, Fig.1 (b) | |