ABSTRACT
Tumors of the chemoreceptor system are quite rare, and are usually considered to be benign, but locally invasive. We report a case of a glomus juxtavagale tumor with metastasis to cervical lymph nodes, lung, and bone. Review of the literature shows that 19% of similar cases reported also showed distant metastases, a rate significantly higher than for other chemodectomas. Clinically and histologically, benign and malignant tumors are identical, so only the demonstration of distant metastasis indicates malignant neoplasm. Primary treatment is surgical, but radiotherapy is useful for palliation.
Subject(s)
Glomus Jugulare Tumor/pathology , Paraganglioma, Extra-Adrenal/pathology , Vagus Nerve/pathology , Aged , Diagnostic Errors , Female , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Pharyngeal Neoplasms/pathologyABSTRACT
Hemilaryngectomy with removal of a greater part or all of the arytenoid was done in 79 patients with good functional results with an overall cure rate of 94 percent. The survival rate for the primary modality of therapy was 90 percent.
Subject(s)
Carcinoma, Papillary/surgery , Carcinoma, Squamous Cell/surgery , Glottis , Laryngeal Neoplasms/surgery , Adult , Aged , Carcinoma, Papillary/mortality , Carcinoma, Squamous Cell/mortality , Female , Follow-Up Studies , Glottis/surgery , Humans , Laryngeal Neoplasms/mortality , Laryngectomy/methods , Male , Middle Aged , Neoplasm Recurrence, LocalABSTRACT
Seventy-six patients with glomus tumors were evaluated. The incidenc- of cranial nerve paralysis in 37 percent and the incidence of intracranial extension is 14.6 percent. Jugular foramen syndrome is associated with 50 percent, and hypoglossal nerve involvement with 75 percent incidence of posterior fossa extension. Horner's syndrome is associated with 50 percent of middle cranial fossa invasion. The incidence of CNS tumor involvement with cranial nerve paralysis (not including VIIth nerve) is 52 percent.
Subject(s)
Head and Neck Neoplasms/diagnosis , Neurologic Manifestations , Paraganglioma, Extra-Adrenal/diagnosis , Ear Neoplasms/diagnosis , Ear Neoplasms/diagnostic imaging , Facial Paralysis/diagnosis , Head and Neck Neoplasms/diagnostic imaging , Horner Syndrome/diagnosis , Humans , Papilledema/diagnosis , Paraganglioma, Extra-Adrenal/diagnostic imaging , Peripheral Nervous System Diseases/diagnosis , Radiography , Trigeminal Neuralgia/diagnosis , Vagus Nerve , Vocal Cord Paralysis/diagnosisSubject(s)
Carcinoma, Squamous Cell/surgery , Glottis , Laryngeal Cartilages , Laryngeal Neoplasms/surgery , Adult , Aged , Carcinoma, Squamous Cell/mortality , Carcinoma, Squamous Cell/radiotherapy , Humans , Laryngeal Neoplasms/mortality , Laryngeal Neoplasms/radiotherapy , Laryngectomy/methods , Middle Aged , Neoplasm Metastasis , Neoplasm Recurrence, LocalABSTRACT
Eight of 76 glomus tumors in the head and neck region are multiple. The most common association is with carotid body tumors; the most common pattern is an ipsilateral glomus tympanicum and carotid body tumor. The approach to clinical evaluation is based on a complete otolaryngologic, neurologic, and neuroradiologic evaluation of all patients with glomus tumors. The rationale for priorities in management is the resection of the most dangerous lesions first. This study confirms the previous observations that glomus tumors have a definite proclivity for multicentricity (10 percent) and a high incidence for other associated malignancies (8 percent).
Subject(s)
Neoplasms, Multiple Primary , Paraganglioma, Extra-Adrenal , Adult , Aged , Carotid Body Tumor/diagnostic imaging , Carotid Body Tumor/epidemiology , Carotid Body Tumor/surgery , Female , Follow-Up Studies , Glomus Jugulare Tumor/diagnostic imaging , Glomus Jugulare Tumor/epidemiology , Glomus Jugulare Tumor/surgery , Humans , Male , Middle Aged , Missouri , Neoplasms, Multiple Primary/diagnostic imaging , Neoplasms, Multiple Primary/epidemiology , Neoplasms, Multiple Primary/surgery , Paraganglioma, Extra-Adrenal/diagnostic imaging , Paraganglioma, Extra-Adrenal/epidemiology , Paraganglioma, Extra-Adrenal/surgery , RadiographyABSTRACT
Seventy-five patients with glomus tumors in the head and neck had a 37% incidence of cranial nerve paralysis and a 14.6% incidence of intracranial extension. Jugular foramen syndrome is associated with 50% and hypoglossal nerve involvement with 75% posterior fossa tumor invasion. Horner's syndrome is associated with 50% middle cranial fossa tumor invasion. The incidence of central nervous system (CNS) involvement with cranial NERVE PARALYSIS (NOT INCLUDING VII nerve) is 52%. Otologic findings and VII nerve paralysis did not correlate with tumor resectability, CNS extension, and prognosis.
