A rare case of a middle ear glomangioma

Abstract

Glomus tumors are benign hyperplasia of glomus bodies, and they are rarely found in the head and neck. The middle ear is an exceptionally rare site for a true glomus tumor, and there are only three previously reported cases in this location. Glomus tumors are etiologically different than glomus tympanicum, which are paragangliomas of the middle ear that are often mistakenly referred to as “glomus tumors.” This is a common misconception due to the “glomus” misnomer. We report a case of a patient diagnosed with a middle ear glomangioma after initially presenting to our clinic with tinnitus and hearing loss. The mass was surgically removed through a transcanal approach with carbon dioxide laser and sharp dissection. Literature review is also reported and revealed similar presentations in patients with middle ear glomangiomas.

Glomangioma of the External Ear: A Case Report

“…The tumors stain positively for smooth muscle markers, particularly SMA, as was used in the present case. 1 Glomangiomas share a similar immunohistochemistry profile with other tumors that arise from perivascular muscle cells. 2 This category of benign neoplasms includes myopericytomas, angioleiomyomas, and myofribromas.…”

“…They often present in the extremities where a high density of glomus bodies exist; however, a few cases have been reported within the nasal septum and paranasal sinuses, orbit, lip, and middle ear space. [1][2][3] Our Editor's Note: This Manuscript was accepted for publication on November 01, 2023.…”

“…Glomus tumors are rare soft tissue neoplasms of mesenchymal origin that result from undifferentiated smooth muscle (glomus) cell hyperplasia, similar to what is found in the normal glomus body. 1,2 Glomus bodies are cutaneous structures that consist of neuromyoarterial cells and play a role in thermoregulation. They are specifically found in the dermal layer of skin, most commonly in the hands and feet.…”

“…Glomus tumors are further divided into three separate subtypes based on histopathological examination-solid type, glomangioma or glomuvenous malformation (GVM), and glomangiomyoma. 1,2 Glomangiomas are the second most common subtype and are characterized by tumor cells associated with prominent vascularity.…”

“…Glomus tumors are separate entities from the misnomers “glomus tympanicum” and “glomus jugulare” which fall under the category of paragangliomas, of neuroendocrine origin. Glomus tumors are further divided into three separate subtypes based on histopathological examination—solid type, glomangioma or glomuvenous malformation (GVM), and glomangiomyoma 1,2 . Glomangiomas are the second most common subtype and are characterized by tumor cells associated with prominent vascularity.…”