Assuntos
Neoplasias da Orelha/diagnóstico , Células Endoteliais/patologia , Tumor do Glomo Jugular/diagnóstico , Tumor de Glomo Timpânico/diagnóstico , Paraganglioma/diagnóstico , Adulto , Contagem de Células , Morte Celular , Progressão da Doença , Neoplasias da Orelha/metabolismo , Neoplasias da Orelha/patologia , Células Endoteliais/metabolismo , Células Endoteliais/fisiologia , Tumor do Glomo Jugular/metabolismo , Tumor do Glomo Jugular/patologia , Tumor de Glomo Timpânico/metabolismo , Tumor de Glomo Timpânico/patologia , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/metabolismo , Recidiva Local de Neoplasia/patologia , Degeneração Neural , Paraganglioma/metabolismo , Paraganglioma/patologia , Adulto JovemRESUMO
OBJECTIVE: To report the safe management and treatment of a catecholamine-secreting tympanicum glomus tumour. CASE REPORT: 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. CONCLUSION: 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.
