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A Rare Differential of Epistaxis
Inemesit Akpan1, Ijeoma Orabueze2, Uwagbae Ibizugbe3
1Internal Medicine, Piedmont Athens Regional Medical Center, Georgia, USA.
Cureus
|June 10, 2024
Summary
A rare glomus tympanicum tumor presented unusually with severe bleeding, not typical ear symptoms. Prompt embolization and resection were crucial for managing this hypervascular middle ear tumor.
Area of Science:
- Otolaryngology
- Vascular Tumors
- Diagnostic Imaging
Background:
- Glomus tympanicum tumors are rare, slow-growing neoplasms in the middle ear.
- They typically present with pulsatile tinnitus and conductive hearing loss.
- Management can be complex due to hypervascularity and location.
Observation:
- A 48-year-old female presented with sudden, large-volume hemoptysis and epistaxis.
- Physical examination revealed a vascular mass in the right ear.
- MRI confirmed a 3.7 cm hypervascular glomus tympanicum in the right middle ear.
Findings:
- The tumor extended into the external auditory canal, eustachian tube, and nasopharynx.
- Massive epistaxis was suspected and treated urgently via embolization.
- Subsequent tumor resection was performed.
Implications:
- This case highlights atypical presentations of glomus tympanicum, emphasizing epistaxis over classic ear symptoms.
- Recognizing massive epistaxis, even without anterior nasal bleeding, is critical for timely diagnosis.
- Avoid probing these tumors to prevent life-threatening hemorrhage.
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