Tumores glômicos do osso temporal: relato de 6 casos

Arruda, Walter Oleschko; Teive, Hélio A. Ghizoni; Torres, Luiz F. Bleggi; Ramina, Ricardo; Parolim, Mônica Konoke F.; Maniglia, João J.; Barrionuevo, Carlos E.

doi:10.1590/S0004-282X1989000100007

Resumos

Os autores apresentam os achados clínicos, radiológicos e anátomo-patologicos de 6 casos de tumor glômico de osso temporal. Cinco pacientes eram do sexo feminino; a idade variava de 22 a 76 anos (média 48 anos). As manifestações clínicas predominantes foram hipoacusia, zumbido e achados otoscópicos sugestivos do diagnóstico. São revistos e discutidos vários aspectos relacionados à origem e fisiopatogênese dos tumores glômicos, assim como seu diagnóstico e tratamento.

The authors review the clinical, radiological and pathological features of 6 cases of glomus tumors of the temporal bone. Out of the 6 patients, 5 were female; age was distributed between 22 and 76 years (mean 48 years). The main clinical features were hypoacusia, tinnitus and otoscopic findings suggestive of the diagnosis. In one case was noted the concomitant presence of a neurinoma of the VIII cranial nerve with a ipsilateral glomus tumor, and in another case there was a concomitancy of carotid body tumor with temporal glomus jugularis tumor. Metastases were not observed in any case. Tumoral lesions were successfully ressected employing microsurgical techniques and a multidisciplinary staff involving neurosurgeons, head and neck surgeons and otolaryngologists. Radioteraphy was not employed, neither pre-operative embolization. Some aspects related to the nosology, embriology, pathophysiology, diagnosis and treatment of this interesting type of neoplasms are discussed.

Tumores glômicos do osso temporal: relato de 6 casos

Glomic tumors of the temporal bone: report of 6 cases

Walter Oleschko Arruda^I; Hélio A. Ghizoni Teive^II; Luiz F. Bleggi Torres^III; Ricardo Ramina^IV; Mônica Konoke F. Parolim^II; João J. Maniglia^V; Carlos E. Barrionuevo^VI

^IUnidade de Ciências Neurológicas, Casa de Saúde São Vicente; Hospital de Clínicas da Universidade Federal do Paraná (UFPR): Neurologista, Bolsista do CNPq

^IIUnidade de Ciências Neurológicas, Casa de Saúde São Vicente; Hospital de Clínicas da Universidade Federal do Paraná (UFPR): Neurologista

^IIIUnidade de Ciências Neurológicas, Casa de Saúde São Vicente; Hospital de Clínicas da Universidade Federal do Paraná (UFPR): Neuropatologista

^IVUnidade de Ciências Neurológicas, Casa de Saúde São Vicente; Hospital de Clínicas da Universidade Federal do Paraná (UFPR): Neurocirurgião

^VUnidade de Ciências Neurológicas, Casa de Saúde São Vicente; Hospital de Clínicas da Universidade Federal do Paraná (UFPR): Professor-Assistente de Otorrinolaringologia, UFPR

^VIUnidade de Ciências Neurológicas, Casa de Saúde São Vicente; Hospital de Clínicas da Universidade Federal do Paraná (UFPR): Professor-Adjunto de Otorrinolaringologia, UFPR

RESUMO

Os autores apresentam os achados clínicos, radiológicos e anátomo-patologicos de 6 casos de tumor glômico de osso temporal. Cinco pacientes eram do sexo feminino; a idade variava de 22 a 76 anos (média 48 anos). As manifestações clínicas predominantes foram hipoacusia, zumbido e achados otoscópicos sugestivos do diagnóstico. São revistos e discutidos vários aspectos relacionados à origem e fisiopatogênese dos tumores glômicos, assim como seu diagnóstico e tratamento.

SUMMARY

The authors review the clinical, radiological and pathological features of 6 cases of glomus tumors of the temporal bone. Out of the 6 patients, 5 were female; age was distributed between 22 and 76 years (mean 48 years). The main clinical features were hypoacusia, tinnitus and otoscopic findings suggestive of the diagnosis. In one case was noted the concomitant presence of a neurinoma of the VIII cranial nerve with a ipsilateral glomus tumor, and in another case there was a concomitancy of carotid body tumor with temporal glomus jugularis tumor. Metastases were not observed in any case. Tumoral lesions were successfully ressected employing microsurgical techniques and a multidisciplinary staff involving neurosurgeons, head and neck surgeons and otolaryngologists. Radioteraphy was not employed, neither pre-operative embolization. Some aspects related to the nosology, embriology, pathophysiology, diagnosis and treatment of this interesting type of neoplasms are discussed.

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Full text available only in PDF format.

Unidade de Ciências Neurológicas - Rua Gonçalves Dias 71S - 80240 Curitiba PR - Brasil

1. Alford BR, Gluiford FR - A comprehensive study of tumors of the glomus jugulare. Laryngoscope 72:765, 1962.
2. Anderson JR, Gullan RW - Paraganglioma of the cauda equina: a case report. J Neurol Neurosurg Psychiat 50:100, 1987.
3. Basma NJ, Robin PE - Glomus jugulare tumour masquerading as «idiopathic» facial nerve palsy. J Laryngol Otol 101:605, 1987.
4. Bickerstaff ER, Howell JS - The neurological importance of tumors of the glomus jugularis. Brain 76(part 4):576, 1953.
5. Brown JS - Glomus jugulare tumors revisited: a ten year statistical follow-up of 231 cases. Laryngoscope 95:284, 1985.
6. Cece JA, Lawson W, Eden AR, Biller HF, Parisier SC - Complications in the management of large glomus jugulare tumors. Laryngoscope 97:152, 1987.
7. Chusid JG - Correlative Neuroanatomy and Functional Neurology. Lange, California, 1976.
8. DeAngelis LM, Kelleher MB, Post KD, Fetell MR - Multiple paragangliomas in neurofibromatosis: a new neuroendocrine neoplasia. Neurology 37:129, 1987.
9. DeLellis RA, Roth JA - Norepinephrine in a glomus jugulare tumors. Arch Pathol 92:73, 1971.
10. Estopinan V, Domínguez JR, Trujillo M, Varela C - Quemodectoma del glomus yugularis productor de catecolaminns: aportación de un nuevo caso. Rev Clin Esp 178:248, 1986.
11. Farrior JB III, Hyams VJ, Benkee RH. Farrior JB - Carcinoid apudoma arising in a glomus jugulare tumor: review of endocrine activity in glomus jugulare, tumors. Laryngoscope 90:110, 1980.
12. Fisch IT - Infratemporal approach to tumors of the temporal bone and base of the skull. J Laryngo Otol 92:949, 1978.
13. Fuller AM, Brown HA, Harrison EG, Siekert RG - Chemodectomas of the glomus jugulare tumors. Laryngoscope 76:218, 1977.
14. Ganong WF - Review of Medical Physiology. Ed 8. Lange, California, 1977.
15. George B - Les tumeurs dites du glomus jugulaire: présentation générale. Neuro-chirurgie 31:333, 1985.
16. Gertler R, Sellars SL - Paragangliomas of the petrous temporal bone. S Afr Med J 66:614, 1984.
17. Glasscock ME III, Harris PF, Newsome G - Glomus tumors: diagnosis and treatment. Laryngoscope 84:2006, 1974.
18. Glasscock ME Hi, Dickins JRE, Jackson CE, Wie.t RJ - Vascular anomalies of the middle ear. Laryngoscope 90:77, 1980.
19. Guild SR - A hitherto unrecognized structure, the glomus jugularis in man. Anat Rec 79(suppl 2):28, 1941.
20. Guild SR - Glomus jugulare in man. Ann Otol Rhinol Laryngol 62:1045, 1953.
21. Hamid Q, Varndell IM, Ibrahim NB, Mingazzini P, Polak JM - Extraadrenal paragangliomas: an immunocytochemical and ultrastructural report. Cancer 60:1776, 1987.
22. Hatfield PM, James AE. Schulz MD - Chemodectomas of the glomus jugulare. Cancer 30:1164, 1972.
23. Hennessy O, Jamleson CW, Allison DJ - Pre-operative embolisation of a chemodectoma. Br J Radiol 57:845, 1984.
24. Hoefler H, Lammer J, Stammberger H, Gutschi S, Clarici G, Ratschek M - Jugulotympanisches Paraganglion. Wien Klin Wchnschr 97:530, 1985.
25. Jackson CG, Glasscock ME III, Harris PF - Glomus tumors: diagnosis, classification, and management of large lesions. Arch Otolaryngol 108:401, 1982.
26. Kaye AH, Hahn JF, Kinney SE, Hardy RW, Bay JW - Jugular foramen schwannomas. J Neurosurg 60:1045, 1984.
27. Koenig H, Lenz M, Sauter R - Temporal bone region: high resolution MR imaging using surface coils. Radiology 159:191, 1986.
28. Kornblith PL, Walker MD, Cassady JR - Neurologic Oncology. Lippincott, Philadelphia, 1987
29. Lack EE, Cubilla AL, Woodruff JM, Farr HW - Paragangliomas of the head and neck region: a clinical study of 69 patients. Cancer 39:397, 1977.
30. Larson TC III, Reese DF, Baker HLJr, McDonald TJ - Glomus tympanicum chemodectomas: radiographic and clinical characteristics. Radiology 163:801, 1987.
31. Lattes R, Waltner JG - Nonchromaffin paraganglioma of the middle ear (carotid-body-like tumor; glomus-jugulare tumor). Cancer 2:447, 1949.
32. Lattes R - Nonchromoaffin Paraganglion of ganglion nodosum, carotid body, and aortic-arch bodies. Cancer 3:667, 1950.
33. Lawson W - Glomus bodies and tumours. NY State J Med 8:1567, 1980.
34. Lawson W - The neuroendocrine nature of the glomus cells: an experimental, ultrastructural, and histochemical tissue culture study. Laryngoscope 90:120, 1980.
35. Lederer FL, Skolnik EM, Soboroff BJ, Fornatto EJ - Nonchromoaffin paraganglioma of the head and neck. Ann Otol Rhinol Laryngol 67:305, 1958.
36. Lishajko F - Release and uptake of dopamine in isolated granules from a carotid body tumor. Acta Physiol Scand 79:533, 1970.
37. Lo WWM, Solti-Bohman LG, Lambert PR P High-resolution CT in the evaluation of glomus tumors of the temporal bone. Radiology 150:737, 1984.
38. Lo WWM, Solti-Bohman LG - High-resolution CT of the jugular foramen: anatomy and vascular variants and anomalies. Radiology 150:743, 1984.
39. Marshall RB. Horn RCJr - Nonchromaffin paraganglioma: a comparative study. Cancer 14:779, 1961.
40. Mather SP, Webster NE - Tumours of the glomus jugulare: case report and anaesthetic management for the combined two stage operation. Anaesthesia 41:856, 1986.
41. Mulligan RM - Chemodectomas in the dog. Am J Pathol 26:680, 1950.
42. Oberman HA, Holtz F, Sheffer LA, Magielski JE - Chemodectomas (nonchromaffin paragangliomas) of the head and neck: a clinicopathologic study. Cancer 21:838, 1968.
43. Oolsen WL, Dillon WP, Kelly WM, Norman D, Brant-Zawadzki M, Newton TH - MR imaging of paragangliomas. Am J Radiol 148:201, 1987.
44. Pearse Age, Polak GM - Endocrine tumors of neural crest origin: neurolophomas, apudomas and the APUD concept. Med Biol 52:3, 1974.
45. Ramina R, Maniglia JJJ, Prestes ACF, Arruda WO - Tratamento cirúrgico dos tumores do glomus jugular. Tema livre. XI Congresso Brasileiro de Cirurgia de Cabeça e Pescoço, 2-5 de setembro de 1987, São Paulo, São Paulo.
46. Rosenwascer H - Carotid body tumor of the middle ear and mastoid. Arch Otolaryngol 41:64, 1945.
47. Schermer KL, Pontius EE. Dziabis MD, McQuiston RJ - Tumors of the glomus jugulare and glomus tympanicum. Cancer 19:1273, 1966.
48. Schwaber MK, Glasscock ME, Jackson CG, Nissen AJ, Smith PG - Diagnosis and management of cathecolamine secreting glomus tumors. Laryngoscope 94:1008, 1984.
49. Siekert RG - Neurologic manifestations of tumors of the glomus jugulare, chemodectoma, nonchromaffin paraganglioma or carotid-body-like tumor. Arch Neurol Psych 71:1, 1956.
50. Simpson GT II, Konrad HR, Takahashi M, House J - Immediate postembolization excision of glomus jugulare tumors. Arch Otolaryngol 105:639, 1979.
51. Spector GJ, Maisel RH. Ogura JH - Glomus tumors in the middle ear: I. An analysis of 46 patients. Laryngoscope 83:1652, 1973.
52. Spector GJ, Compagno J, Perez CA, Maisel RH, Ogura JH - Glomus jugulare tumors: effects of radiotherapy. Cancer 35:1316, 1975.
53. Spector GJ, Druck NS, Gado M - Neurologic manifestations of glomus tumors in the head and neck. Arch Neurol 33:270, 1976.
54. Sykes JM, Ossoff RH - Paragangliomas of the head and neck. Otolaryngol Clin N Am 19:755, 1986.
55. Thorbeck RV, Valentin OIM, Ruiz Morales M - Non-chromoaffin paraganglioma of the orbit. Zntrbl Chir 111:46, 1986.
56. Toker C - Ultrastructure of a chemodectoma. Cancer 20:271, 1967.
57. Warren WH, Caldarelli DD, Lee I, Javid H, Gloud VE - Neuroendocrine markers in paragangliomas of the head and neck. Ann Otol Rhinol Laryngol 94:555, 1985.
58. Warren WH, Lee I, Gould VE, Memoli VA, Jao W - Paragangliomas of the head and neck: ultrastructural and immunohistochemical analysis. Ultrastruct Pathol 9:333, 1985.
59. Wilbourn RB - Current status of the apudomas. Ann Surg 185:1, 1977.
60. Winship T. Klopp CT, Jenkins WH - Glomurs-jugularis tumors. Cancer 1:441, 1948.

Datas de Publicação

Publicação nesta coleção
06 Jun 2011
Data do Fascículo
Mar 1989

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Alford BR, Gluiford FR - A comprehensive study of tumors of the glomus jugulare. Laryngoscope 72:765, 1962.

[2] 2. Anderson JR, Gullan RW - Paraganglioma of the cauda equina: a case report. J Neurol Neurosurg Psychiat 50:100, 1987.

[3] 3. Basma NJ, Robin PE - Glomus jugulare tumour masquerading as «idiopathic» facial nerve palsy. J Laryngol Otol 101:605, 1987.

[4] 4. Bickerstaff ER, Howell JS - The neurological importance of tumors of the glomus jugularis. Brain 76(part 4):576, 1953.

[5] 5. Brown JS - Glomus jugulare tumors revisited: a ten year statistical follow-up of 231 cases. Laryngoscope 95:284, 1985.

[6] 6. Cece JA, Lawson W, Eden AR, Biller HF, Parisier SC - Complications in the management of large glomus jugulare tumors. Laryngoscope 97:152, 1987.

[7] 7. Chusid JG - Correlative Neuroanatomy and Functional Neurology. Lange, California, 1976.

[8] 8. DeAngelis LM, Kelleher MB, Post KD, Fetell MR - Multiple paragangliomas in neurofibromatosis: a new neuroendocrine neoplasia. Neurology 37:129, 1987.

[9] 9. DeLellis RA, Roth JA - Norepinephrine in a glomus jugulare tumors. Arch Pathol 92:73, 1971.

[10] 10. Estopinan V, Domínguez JR, Trujillo M, Varela C - Quemodectoma del glomus yugularis productor de catecolaminns: aportación de un nuevo caso. Rev Clin Esp 178:248, 1986.

[11] 11. Farrior JB III, Hyams VJ, Benkee RH. Farrior JB - Carcinoid apudoma arising in a glomus jugulare tumor: review of endocrine activity in glomus jugulare, tumors. Laryngoscope 90:110, 1980.

[12] 12. Fisch IT - Infratemporal approach to tumors of the temporal bone and base of the skull. J Laryngo Otol 92:949, 1978.

[13] 13. Fuller AM, Brown HA, Harrison EG, Siekert RG - Chemodectomas of the glomus jugulare tumors. Laryngoscope 76:218, 1977.

[14] 14. Ganong WF - Review of Medical Physiology. Ed 8. Lange, California, 1977.

[15] 15. George B - Les tumeurs dites du glomus jugulaire: présentation générale. Neuro-chirurgie 31:333, 1985.

[16] 16. Gertler R, Sellars SL - Paragangliomas of the petrous temporal bone. S Afr Med J 66:614, 1984.

[17] 17. Glasscock ME III, Harris PF, Newsome G - Glomus tumors: diagnosis and treatment. Laryngoscope 84:2006, 1974.

[18] 18. Glasscock ME Hi, Dickins JRE, Jackson CE, Wie.t RJ - Vascular anomalies of the middle ear. Laryngoscope 90:77, 1980.

[19] 19. Guild SR - A hitherto unrecognized structure, the glomus jugularis in man. Anat Rec 79(suppl 2):28, 1941.

[20] 20. Guild SR - Glomus jugulare in man. Ann Otol Rhinol Laryngol 62:1045, 1953.

[21] 21. Hamid Q, Varndell IM, Ibrahim NB, Mingazzini P, Polak JM - Extraadrenal paragangliomas: an immunocytochemical and ultrastructural report. Cancer 60:1776, 1987.

[22] 22. Hatfield PM, James AE. Schulz MD - Chemodectomas of the glomus jugulare. Cancer 30:1164, 1972.

[23] 23. Hennessy O, Jamleson CW, Allison DJ - Pre-operative embolisation of a chemodectoma. Br J Radiol 57:845, 1984.

[24] 24. Hoefler H, Lammer J, Stammberger H, Gutschi S, Clarici G, Ratschek M - Jugulotympanisches Paraganglion. Wien Klin Wchnschr 97:530, 1985.

[25] 25. Jackson CG, Glasscock ME III, Harris PF - Glomus tumors: diagnosis, classification, and management of large lesions. Arch Otolaryngol 108:401, 1982.

[26] 26. Kaye AH, Hahn JF, Kinney SE, Hardy RW, Bay JW - Jugular foramen schwannomas. J Neurosurg 60:1045, 1984.

[27] 27. Koenig H, Lenz M, Sauter R - Temporal bone region: high resolution MR imaging using surface coils. Radiology 159:191, 1986.

[28] 28. Kornblith PL, Walker MD, Cassady JR - Neurologic Oncology. Lippincott, Philadelphia, 1987

[29] 29. Lack EE, Cubilla AL, Woodruff JM, Farr HW - Paragangliomas of the head and neck region: a clinical study of 69 patients. Cancer 39:397, 1977.

[30] 30. Larson TC III, Reese DF, Baker HLJr, McDonald TJ - Glomus tympanicum chemodectomas: radiographic and clinical characteristics. Radiology 163:801, 1987.

[31] 31. Lattes R, Waltner JG - Nonchromaffin paraganglioma of the middle ear (carotid-body-like tumor; glomus-jugulare tumor). Cancer 2:447, 1949.

[32] 32. Lattes R - Nonchromoaffin Paraganglion of ganglion nodosum, carotid body, and aortic-arch bodies. Cancer 3:667, 1950.

[33] 33. Lawson W - Glomus bodies and tumours. NY State J Med 8:1567, 1980.

[34] 34. Lawson W - The neuroendocrine nature of the glomus cells: an experimental, ultrastructural, and histochemical tissue culture study. Laryngoscope 90:120, 1980.

[35] 35. Lederer FL, Skolnik EM, Soboroff BJ, Fornatto EJ - Nonchromoaffin paraganglioma of the head and neck. Ann Otol Rhinol Laryngol 67:305, 1958.

[36] 36. Lishajko F - Release and uptake of dopamine in isolated granules from a carotid body tumor. Acta Physiol Scand 79:533, 1970.

[37] 37. Lo WWM, Solti-Bohman LG, Lambert PR P High-resolution CT in the evaluation of glomus tumors of the temporal bone. Radiology 150:737, 1984.

[38] 38. Lo WWM, Solti-Bohman LG - High-resolution CT of the jugular foramen: anatomy and vascular variants and anomalies. Radiology 150:743, 1984.

[39] 39. Marshall RB. Horn RCJr - Nonchromaffin paraganglioma: a comparative study. Cancer 14:779, 1961.

[40] 40. Mather SP, Webster NE - Tumours of the glomus jugulare: case report and anaesthetic management for the combined two stage operation. Anaesthesia 41:856, 1986.

[41] 41. Mulligan RM - Chemodectomas in the dog. Am J Pathol 26:680, 1950.

[42] 42. Oberman HA, Holtz F, Sheffer LA, Magielski JE - Chemodectomas (nonchromaffin paragangliomas) of the head and neck: a clinicopathologic study. Cancer 21:838, 1968.

[43] 43. Oolsen WL, Dillon WP, Kelly WM, Norman D, Brant-Zawadzki M, Newton TH - MR imaging of paragangliomas. Am J Radiol 148:201, 1987.

[44] 44. Pearse Age, Polak GM - Endocrine tumors of neural crest origin: neurolophomas, apudomas and the APUD concept. Med Biol 52:3, 1974.

[45] 45. Ramina R, Maniglia JJJ, Prestes ACF, Arruda WO - Tratamento cirúrgico dos tumores do glomus jugular. Tema livre. XI Congresso Brasileiro de Cirurgia de Cabeça e Pescoço, 2-5 de setembro de 1987, São Paulo, São Paulo.

[46] 46. Rosenwascer H - Carotid body tumor of the middle ear and mastoid. Arch Otolaryngol 41:64, 1945.

[47] 47. Schermer KL, Pontius EE. Dziabis MD, McQuiston RJ - Tumors of the glomus jugulare and glomus tympanicum. Cancer 19:1273, 1966.

[48] 48. Schwaber MK, Glasscock ME, Jackson CG, Nissen AJ, Smith PG - Diagnosis and management of cathecolamine secreting glomus tumors. Laryngoscope 94:1008, 1984.

[49] 49. Siekert RG - Neurologic manifestations of tumors of the glomus jugulare, chemodectoma, nonchromaffin paraganglioma or carotid-body-like tumor. Arch Neurol Psych 71:1, 1956.

[50] 50. Simpson GT II, Konrad HR, Takahashi M, House J - Immediate postembolization excision of glomus jugulare tumors. Arch Otolaryngol 105:639, 1979.

[51] 51. Spector GJ, Maisel RH. Ogura JH - Glomus tumors in the middle ear: I. An analysis of 46 patients. Laryngoscope 83:1652, 1973.

[52] 52. Spector GJ, Compagno J, Perez CA, Maisel RH, Ogura JH - Glomus jugulare tumors: effects of radiotherapy. Cancer 35:1316, 1975.

[53] 53. Spector GJ, Druck NS, Gado M - Neurologic manifestations of glomus tumors in the head and neck. Arch Neurol 33:270, 1976.

[54] 54. Sykes JM, Ossoff RH - Paragangliomas of the head and neck. Otolaryngol Clin N Am 19:755, 1986.

[55] 55. Thorbeck RV, Valentin OIM, Ruiz Morales M - Non-chromoaffin paraganglioma of the orbit. Zntrbl Chir 111:46, 1986.

[56] 56. Toker C - Ultrastructure of a chemodectoma. Cancer 20:271, 1967.

[57] 57. Warren WH, Caldarelli DD, Lee I, Javid H, Gloud VE - Neuroendocrine markers in paragangliomas of the head and neck. Ann Otol Rhinol Laryngol 94:555, 1985.

[58] 58. Warren WH, Lee I, Gould VE, Memoli VA, Jao W - Paragangliomas of the head and neck: ultrastructural and immunohistochemical analysis. Ultrastruct Pathol 9:333, 1985.

[59] 59. Wilbourn RB - Current status of the apudomas. Ann Surg 185:1, 1977.

[60] 60. Winship T. Klopp CT, Jenkins WH - Glomurs-jugularis tumors. Cancer 1:441, 1948.