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Multicentric chemodectoma in the head and neck.

T E Havas¹, P J Gullane

¹Department of Otolaryngology, Prince of Wales Hospital, Randwick, New South Wales.

The Australian and New Zealand Journal of Surgery

|August 1, 1989

Summary

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This study presents a rare multicentric chemodectoma case involving glomus vagale and glomus tympanicum tumors. Despite being asymptomatic, the patient had elevated urinary catecholamines, indicating tumor biochemical activity.

Area of Science:

Neuro-oncology
Vascular Surgery
Endocrinology

Background:

Chemodectomas, also known as glomus tumors, are rare neuroendocrine neoplasms.
Multicentricity in chemodectomas is uncommon, particularly involving the vagus nerve and tympanicum.
Biochemical activity in asymptomatic tumors can be challenging to detect.

Observation:

A case of multicentric chemodectoma with concurrent glomus vagale and glomus tympanicum is described.
The patient was asymptomatic but exhibited elevated urinary catecholamines.
Multicentricity was diagnosed via selective carotid arteriography.

Findings:

Pre-operative embolization with Ivalon facilitated intra-operative hemostasis.
Histological confirmation of Ivalon within the tumor specimen.

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The glomus tympanicum tumor was managed with embolization alone, with long-term efficacy pending.

Vagus nerve function recovery was incomplete two years post-operatively.

Implications:

This case highlights the importance of biochemical evaluation in suspected chemodectomas.
Selective embolization is a viable adjunct for surgical hemostasis in complex head and neck tumors.
Further research is needed to establish the efficacy of embolization as a standalone treatment for glomus tympanicum.
Understanding the natural history and functional outcomes after vagus nerve preservation is crucial.