​Glomus Tumor

Glomus tumors, or paragangliomas, are slow-growing, benign tumors of the neuroendocrine tissues in the body. They are rare but most commonly occur in the head, neck, and adrenal gland. In very rare situations, they are malignant.

Glomus tumors occur in three places in the head and neck:

• Middle ear
• Jugular bulb
• Carotid artery

On this page:

• What Is a Glomus Tumor?
• What Are the Symptoms of Glomus Tumors?
• How Do You Diagnose a Glomus Tumor?
• How Do You Treat Glomus Tumors?

What Is a Glomus Tumor?

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.

What are the types of glomus tumors?

In the head and neck, glomus tumors can be in the:

• Carotid artery (glomus vagale) — Glomus tumors may also form in the deep neck (parapharyngeal) area along the course of the vagus nerve. These are glomus vagale tumors.
• Jugular bulb (glomus jugulare) — Glomus tumors are most common in this region of the jugular vein just below the middle ear. Tumors in this area may grow into the middle ear, skull base, and cranial cavity.
• Middle ear (glomus tympanicum) — Tumors that start in glomus cells of the middle ear are glomus tympanicum tumors. These are the most common vascular tumors of the middle ear.

What causes glomus tumors?

The exact cause of a glomus tumor is unknown.

What are glomus tumor risk factors?

Glomus tumors are associated with a family of hereditary genetic mutations that can be passed on to your children. It may be important to be tested for these genetic conditions so you make appropriate family planning decisions.

But glomus tumors also may occur without any family history — meaning they can form from gene mutations that happen over time throughout your life.

Back to top

What Are the Signs and Symptoms of Glomus Tumors?

In rare cases, glomus tumors may produce hormones that can cause:

• Anxiety.
• Headaches
• High blood pressure.
• Increased heart rate.

Other symptoms of glomus tumors depend on where the tumors are in your body.

Glomus tympanicum (middle ear) symptoms

• Hearing loss as the mass grows and impedes sound transmission.
• Pulsating sound or ringing from the flow of blood.

Glomus jugulare (jugular bulb) symptoms

Symptoms are like those of glomus tympanicum and may also include:

• Difficulty swallowing.
• Facial nerve weakness or spasm.
• Hearing loss.
• Hoarseness of the voice.
• Pulsing or swishing in the ear.
• Weakness of shoulder movement.
• Weakness of tongue movement.

Glomus vagale (deep neck space) and carotid body tumor (carotid artery) symptoms

• A painless mass in the neck that may be pulsing.
• Difficulty breathing with very large tumors.
• Difficulty swallowing.
• Hoarseness of the voice.
• Weakness of shoulder movement.
• Weakness of tongue movement.

Back to top.

How Do You Diagnose Glomus Tumors?

To diagnose a glomus tumor, your doctor will:

• Ask about symptoms you are having — In the middle ear, most glomus tympanicum or jugulare tumors cause hearing loss and pulsatile tinnitus.
• Do an exam — Doctors do a physical exam to find these tumors, which appear as reddish-blue masses behind the eardrum. They may inspect the vocal cords and back of the throat or neck for other tumors.

• Order imaging and other tests.

Tests to diagnose glomus tumors

Your doctor may order the following tests to diagnose your glomus tumors:

• Angiogram.
• Audiogram.
• CT scan.
• Genetic testing.
• MRI.
• Nuclear medicine scan (such as a DOTA scan).
• Urine or blood tests to screen for tumor-produced hormones.

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.

Back to top.

How Do You Treat Glomus Tumors?

At UPMC, the approach to managing glomus tumors is comprehensive and multidisciplinary. We aim to manage both the tumor itself and the symptoms it can produce.

The multidisciplinary team may include a:

• Audiologist.
• Head and neck surgeon.
• Interventional radiologist.
• Medical oncologist.
• Neurotologist.
• Neurosurgeon.
• Physical therapist. 
• Radiation oncologist. 

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:

• Through a skin crease in the neck.
• Through the ear canal.
• Through the mastoid (bony lump behind the ear), called the transmastoid. 

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.

Transmastoid surgical approach for glomus tumors

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.

Transcervical surgical approach for glomus tumors

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.

Stereotactic radiosurgery for glomus tumors

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.

Why Choose UPMC for Glomus Tumor Care? 

UPMC is a world leader in glomus tumor research.

Researchers are looking at:

• Developing advanced surgical techniques.
• Potential novel treatments in the future. 
• The mechanisms for why they occur.

Back to top.

By UPMC Editorial Staff. Last reviewed on 2024-10-18.