Glomus Jugulare Tumor With Multiple Lower Cranial Nerves Palsy:  Case Report

İpek Midi; Müzeyyen Doğan; Kamuran Urgun; Nazire Afşar

İpek Midi¹, Müzeyyen Doğan², Kamuran Urgun³, Nazire Afşar¹

¹Department Of Neurology, Marmara University, Faculty Of Medicine, İstanbul, Turkey
²Department Of Otorhinolaryngology, Marmara University, Faculty Of Medicine, İstanbul, Turkey
³Department Of Neurosurgery, Marmara University, Faculty Of Medicine, İstanbul, Turkey

Keywords: paraganglioma, glomus jugulare, cranial nerve, gamma knife surgery

Abstract

Scientific BACKGROUND: Glomus jugulare tumor is a rare and mostly benign type of paraganglioma localized in or around the jugular foramen. Pulsatile tinnitus, conductive hearing loss and aural fullness are the most common presenting symptoms. Moreover, it may cause significant lower cranial nerve deficits due to mass effect. Glomus jugulare tumors are generally slow-growing, benign lesions, however; their pronounced local aggressiveness frequently results in severe neurological deficits.

CASE: A 63 year-old woman presented with VIII, IX, X, XI, XIIth cranial nerves palsy on the left side. Cranial imaging revealed a left-sided glomus jugulare tumor. The patient was considered to be of very high risk due to severe local invasion to surrounding bones and close proximity to vital structures and underwent gamma knife surgery.

CONCLUSION: Signs of glomus jugulare tumors are related to tumor localization. These generally appear following a long silent period due to slow growth rate. Surgical option can be limited if the tumor is close to vital structures. Although rare, the diagnosis of glomus jugulare tumor should be kept in mind in cases of slowly developing multiple lower cranial nerves palsy.