Case 15
History:
46 year old male with left sided tinnitus
Findings:
Non enhanced followed by enhanced MRI of the IACs show presence of a homogenously enhancing lesion in the left middle ear. A cerebral angiogram showed the lesion as a contrast blush being fed by the tympanic branch of the ascending hypoglossal artery.
Diagnosis:
Glomus tympanicum
Discussion:
Glomus tympanicum is the most common tumor of the middle ear. The most common symptoms are tinnnitus and hearing loss. At otoscopy, the lesion presents itself as a retrotympanic red purple mass, typically on the cochlear promontory. On imaging, the lesion appears as a globular mass abutting the cochlear promentory with intense enhancement. The lesion can erode and displace the ossicles. Cerebral angiography shows the lesion as a contrast blush being fed by the tympanic branch of the ascending hypoglossal artery.
