gms | German Medical Science

Background: Glomus tumors are highly vascularized, mostly benign and slow-growing neoplasms. These tumors of the head and neck are associated with four primary locations: jugular bulb, middle ear cavity, vagus nerve, carotid body. The last one, also called carotid body tumors, occur at the bifurcation of the common carotid artery. Prefered examinations include contrast-enchanced CT, MRI and angiography. Treatment of choice is surgery. Preoperative embolizations is often used to reduce surgical blood loss.

Case report: A 72-year-old female presented with asymptomatic, nontender, slow-growing, right lateral neck mass. Ultrasonography (US) demonstrated cervical mass below the angle of mandible by lateral margine of submandibular gland. This finding wasn't suggestive of glomus tumor and patient underwent surgical procedure. Intraoperative we found highly vascular tumor localized in the right carotid bifurcation, and further surgical procedure stoped.

Results: CT showed highly vascularized soft-tissue mass at the level of the right carotid bifurcation, splaying the internal and external carotid arteries, and showed compressive effect to larynx and internal jugular vein. The patient underwent next successful surgical excision by vascular surgery team.

Conclusions: Diagnosis of glomus caroticum tumors are impossible by using clinical findings and US alone. Imaging procedures are crucial for proper diagnosis and localization of the tumors. Biopsy is unnecessary and could be very dangerous. A multidisciplinary approach is best choice, which include combined team of otolaringology, vascular surgery and radiology.