Management of a catecholamine-secreting tympanicum glomus tumour: case report.
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.
Kouzaki
H
H
Department of Otolaryngology, Shiga University of Medical Science, Otsu, Shiga, Japan. hkohzaki@belle.shiga-med.ac.jp
Fukui
J
J
Shimizu
T
T
D000368:Aged; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002395:Catecholamines / Q000378:metabolism*; D004428:Ear Neoplasms / Q000378:metabolism / Q000601:surgery*; D005260:Female; D043604:Glomus Tympanicum Tumor / Q000378:metabolism / Q000601:surgery*; D034381:Hearing Loss / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006801:Humans; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D010146:Pain / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000000981:diagnostic imaging / Q000473:pathology
D002395:Catecholamines