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Glomus Jugulare – summary

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Let's move from the carotid body tumor to the

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second most common of the paragangliomas of the

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head and neck, and that is the glomus jugulare.

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This represents between 20 and 30%

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of head neck paragangliomas,

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leaving the glomus vagale to about five to 10% of cases.

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Once again, I want to point out some of the literature that

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has come out of the Johns Hopkins Hospital

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with regard to the paragangliomas

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of the skull base.

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This was a study in which we looked at the

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incidence at which the jugular vein was invaded

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by the tumors of the head and neck.

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And we were specifically looking at glomus

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jugulare versus carotid body tumors

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versus glomus vagale tumors.

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And what you can see is that it is pretty much

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a rule that those tumors that grow from the

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jugular foramen, the glomus jugulare tumors,

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will invade the jugular vein,

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and that is very reliable in distinguishing

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schwannomas from paragangliomas of

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the jugular foramen. However,

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it is also true that glomus vagale

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tumors and some carotid tumors,

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though at a smaller percentage,

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also may occasionally invade the jugular vein.

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So it doesn't help necessarily in defining which

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type of paraganglioma will invade the jugular

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vein, but it does help in distinguishing it, for example,

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from schwannomas or lymph node metastases or

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other tumors that arise in this location.

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As with the carotid body tumors,

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there are multiple different classifications

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of glomus jugularis.

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I should mention that the fourth type of

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paraganglioma that occurs in the head

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neck is the glomus tympanicum.

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These occur in the middle ear cavity,

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and therefore they are more discussed in a

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temporal bone lecture than in

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a head and neck lecture.

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And certainly they are not considered

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carotid space tumors.

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So if we look at the classification

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of the glomus jugulare,

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you see that we have small tumors

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involving the jugular bulb,

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middle ear and mastoid tumors that extend under

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the internal auditory canal that may

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have intracranial extension.

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Then we have tumors that extend into the petrous

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apex and then those that extend beyond the

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Petrous apex into the clivus or

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into the foramen magnum,

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which is that area that we're looking at at

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the skull base and in the neck region.

Report

Description

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Neuroradiology

Neuro

Neoplastic

MRI

Head and Neck

CT

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