Glomus tumors — also known as paragangliomas — of the head and neck are benign (noncancerous) tumors that form from glomus cells.
Glomus tumors are highly vascular and may exist alone or, in around 10% of cases, can occur with multiple glomus tumors in the same person. Rarely, they are associated with other tumors in the adrenal gland, thyroid, or parathyroid glands.
Because glomus tumors tend to be benign and grow slowly, mortality rates are very low. But glomus tumors can damage the tissue and nerves around them as they grow.
In rare cases, glomus tumors can be malignant. They may also produce hormones that can affect your blood pressure, heart rate, and can sometimes make anesthesia dangerous.
In rare cases, glomus tumors may produce hormones that can cause:
Order imaging and other tests.
Because of the association of these tumors with other tumors and because these tumors can produce hormones, it is important to have a full workup before proceeding with management of a glomus tumor.
Sometimes, if the tumor is small and not growing, observation may be recommended. If the tumor is growing or large, the team will recommend treatment. The options are microsurgery or stereotactic radiosurgery.
The aims of microsurgery are to reduce tumor growth, minimize symptoms, and preserve long-term function. The surgical approach may be:
A larger surgery may be needed when the tumor spreads inside the cranial cavity or into the neck.
Stereotactic radiosurgery is an excellent option for some tumors. UPMC offers both LINAC radiotherapy and Gamma Knife® radiosurgery. Stereotactic radiosurgery is painless and uses hundreds of highly focused radiation beams to target tumors and lesions in the brain, with no incisions.
At UPMC, the preferred surgical approach for glomus tumors that grow outside of the middle ear is the transmastoid approach (behind the ear). Your surgical team of experts will include a neurotologist and a neurosurgeon if the tumor spreads into the cranial cavity.
The approach can be tailored to remove part or all of the tumor, depending on nerve function and goals. An angiogram with embolization (blockage of tumor blood flow) often is performed before surgery to reduce bleeding during surgery. UPMC’s approach is a surgical technique that minimizes risk to the facial nerve and other nerves that provide voice and swallowing.
When glomus tumors are based in the neck, a head and neck surgeon or neurosurgeon will access the tumor via a neck dissection. The goal will be to preserve the nerve function that assists with voice and swallowing.
Radiosurgery is a painless technique that requires no incision. Hundreds of highly focused radiation beams target tumors and lesions in the brain.
Radiosurgery aims to prevent further growth of the glomus tumor and may maintain current neurological and hearing function.
Radiosurgery may be the first treatment option in cases where the tumor is not causing mass effect. It may also be a treatment after surgeons remove part of a glomus tumor.
UPMC leads the nation in Gamma Knife techniques with experts using them to treat more than 18,000 people.