Complicated course in the therapy of a large glomus caroticum tumor

Introduction Glomus carotid tumors are rare neoplasias originating from the glomus organ in the area of the bifurcation of the common carotid artery.

The surgical extirpation of the glomus tumor is the only curative therapy. The conservative waiting therapy, the pure primary radiotherapy, the final embolization, the purely surgical procedure as well as the embolization with tumor reduction and subsequent surgical restoration must be seen as therapy options.

Case overview We present the case of a 70-year-old patient with a glomus carotid tumor. MRI and Angio-MRI: Glomus tumor approx. 3.6 cm, supply by the ACI, with strong hyperperfusion, with stenosis of the left ACI and ACE. Under the balloon occlusion an aphasia and hemiplegia of the right side occurred. The balloon was immediately defloated and the patient recovered clinically. In the control series a small dissection in the area of the ACI was observed. After 3 months a preoperative embolization of the tumor was successfully performed. Subsequently, the tumour was completely removed surgically. Postoperatively, a temporary dysphagia, dysphonia and hypoglossal paresis of the left side occurred.

Discussion The preoperative embolization of glomus tumors is controversially discussed in the literature. Several authors reject preoperative embolization for tumor reduction because of possible side effects in terms of hemiparesis and brain nerve damage.

Conclusion Preoperative embolization is an important way to reduce the risk of intraoperative bleeding. In the three cases operated in our clinic last year, embolization proved to be a safe and effective treatment with a good outcome.

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Publication History

Article published online:
10 June 2020