Glomus tumor is a neoplasm of a benign nature, formed from glomus cells (arteriovenous anastomoses). It belongs to the group of neoplasms in the vessels. The mortality rate of patients diagnosed with glomus tumors is on average six percent. The immediate cause of death is the local progression of this pathology. Such tumors most often affect women. They are found mainly in middle age. Recently, however, this disease occurs in young people.
Reasons for the appearance
As with a number of other oncological diseases, there are still no exact reasons for the formation of a glomus tumor. There is a controversial suggestion that its appearance causes injury. Sometimes it is possible to detect influence and heredity. It is worth noting that approximately eight percent of patients had malignant tumors in various organs before the appearance of a glomus tumor.
This education is considered benign, that is, its degeneration is not observed. But at present, such a statement is not entirely clear. There are reports of the transition of such tumors to malignant. If a person has a constant noise in the ear and something incomprehensible pulsates, it is urgent to see a doctor.
Dermatologists and oncologists believe that such neoplasms appear from glomuses. More specifically, from the Sukec-Goyer canal, covered internally by the endothelium, with the surrounding glomus cells. The latter are able to contract, swell and stretch. Thus, they affect the width of the microvascular lumen. Also, glomuses are distinguished by rich innervation.
Description of neoplasms
Arteriolevenous anastomoses are present in the body almost everywhere. That is why we can say that the glomus tumor can appear in any organ. Mostly it affects the phalanges of the fingers, as well as the area of the jugular fossa and middle ear. These neoplasms can be:
Multiple nodes are observed mainly in children. Such a tumor is sometimes found in the parents of the child or other relatives. In this case, the tumors can be located in different parts of the body. From pathologies of a single neoplasm, they are distinguished by a rarer detection on the nail phalanx. Nor are they characterized by intense pain.
Skin swelling
The glomus formation, located alone, externally is a small round knot from 0.1 to 0.6 centimeters in diameter. The sizes of the glomus tumor are individual in all.
The node is most often located on the skin of the finger, mainly in the area of the nail bed. The knot is soft to the touch and forms in the inner epithelial layer of the finger, that is, deep enough. The hue of its color can vary from red to saturated magenta. In the presence of a tumor located in the internal organs, its size can be larger - up to fifteen centimeters. Symptoms of a glomus tumor are quite diverse.
When the node is located under the nail, it is a roundish spot of cyanotic or red color, the size of which reaches 0.5 centimeters. When the pathology is located on the phalanges, it makes itself felt by paroxysmal pain. Unpleasant sensations may be too intense. It is worth considering that various stimuli influence its strengthening.
Other symptoms
Along with finger pain, the following sensations can appear:
- Fear.
- Heat.
- Pain in the heart.
- Severe sweating.
- Hyperemia of the neck, head, face and other vegetative manifestations.
Very often there is a glomus tumor of the middle ear.
Tumor Diagnosis
Most patients are disturbed by the appearance of gradually growing, not causing pain, but pulsating masses on the neck. In some cases, there is a noticeable deterioration in the function of the middle ear. In addition, the following symptoms are possible: difficulty swallowing, hoarseness, a number of problems with the movement of the tongue. More often, in addition to noise, the ear pulsates - this creates a feeling.
Diagnosis begins with a scrupulous examination by the therapist of the medical history and a thorough examination of the affected area. Due to this, it becomes possible to establish the location and size of the tumor, hypothetical anomalies in the nerves affected by the tumor are assumed. Diagnostic procedures also include examination of the ears, as it can help to see the pathology behind the eardrum.
MRI and CT are effective in making a diagnosis. These methods allow you to determine the size of the tumor and to distinguish any other formations.
Quite often, the results of analyzes in angiography (that is, a science that studies the functioning of the blood vessels of the cervical vessels) are used to determine the nature of the supply of the tumor to the blood, as well as to establish ways of its circulation to the brain. In the vast majority of cases, a tumor biopsy cannot be performed before the start of the therapeutic course, as it can cause bleeding.
Varieties of neoplasms
The difference between glomus tumors from each other lies in what elements in them are mainly located - nervous, muscle and arterial. Depending on this classification, the following forms are distinguished:
- Neuromatous.
- Angiomatous.
- Epithelioid.
Multiple neoplasms are similar to cavernous angiomas. They have much less epithelioid tissue.
Tumor in the ear and jugular fossa
The disease often affects the jugular fossa and middle ear cavity. This is manifested by a decrease in labyrinth function and deafness. First, the pulse in the ear. Then, branches of the facial nerve are included in the process. If signs of neuritis of the facial nerve appear, then this is a confirmation of the continued existence of the tumor and affecting the sphere of the jugular fossa.
In the middle ear region, tumors originate from glomus bodies located in adventitious tissue at the bottom of the tympanic cavity of the jugular vein, as well as along the nerve of the same name. they also come from the bodies located along the length of the vagus nerve and the auricular branch related to it. The tumor node includes many capillary, arteriovenous anastomoses, and between them there are globe cells. In the
tympanic cavity of the middle ear, globe cells are directed from the sphere of the jugular vein dome. Then the tumor grows, over time filling the cavity. A gradual hearing loss occurs. Tumor growth continues, the eardrum begins to protrude, and subsequently collapses under the influence of the tumor.
What do patients complain about?
When the neoplasm is located in the bulb or in the cape of the jugular vein, the pain syndrome does not receive a strong expression. Patients complain of throbbing in the ear. When conducting inspection in the early period, the absence of a tympanic membrane defect is detected. However, behind it you can guess the area with the pulsation expressed in it.
Over time, the tumor grows in size, bulges together with the eardrum in the direction of the outer ear from the middle. It should be noted that it becomes very similar to a polyp. When viewed in the later stages, the middle ear bleeds from touching and looks like a polyp. Also, the tumor can spread to areas of the inner ear, cranial cavity, cranial temporal bone.
You can also meet a glomus tumor called paraganglioma. This is a slowly growing benign tumor in the brain, originating from paraganglion cells of the internal jugular vein.
It is distinguished by vascular interlacing with inclusions of glomus cells. Caudal cranial nerves and blood vessels are often involved in their growth. The composition contains chromafin cells, in some cases this is accompanied by active secretion of catecholamines.
In women, it is diagnosed six times more often than in men. On average, the disease is detected at 55 years and older. These neoplasms are detected extracranially or intracranially. In patients, hearing is reduced, tinnitus appears, paresis of the muscles of the face, labile blood pressure is noted. If the case is started, then signs of compression of the brain stem are detected.
Treatment features
In most cases, the treatment is prompt. Glomus lesions are characterized by low sensitivity to radiation therapy. However, in some cases it is recommended. With the help of electrocoagulation, problems are not solved. After a certain time, relapse occurs.
Although glomus tumors of the brain and some other organs are defined as benign, surgical intervention in their treatment is difficult, because they have a strong blood supply. Therefore, there is a risk of serious blood loss. So, if during a finger operation the danger is not too high, then in the inner ear and behind the wall it is higher, which is explained by nearby life structures. Fairly high risk of damage. This is especially true for large tumors included in the oncological process.
In some cases, radiation treatment and surgery are combined. It is recommended that surgery be performed if the pathological process is located only in the middle ear. If the surgical intervention could not eliminate the entire tumor, then radiation may additionally be needed.
When a tumor enters the cranial cavity and destroys bone tissue with its help, only radiation therapy is carried out.
Inability to Operate
If the tumor has grown farther than the middle ear, then the operation can not be done. When the pathology captures the carotid artery channel, a Cooper cryosurgical probe is used. In order to avoid too much blood loss during the operation period, it is necessary to achieve low blood pressure.
When making a diagnosis, it is necessary to distinguish between such tumors:
- Dermatofibroma.
- Angiomyoma
- Oncology of nerve tissue.
- Blue weightless.
- Leiomyoma
Radiosurgery
Gamma Knife radiosurgery has been used to treat tumors since the mid-nineties. Neoplasms are well detected by MRI and rarely invade the brain. Therefore, this type of treatment is very suitable. Radiation therapy is carried out for 4-6 weeks with a long postoperative recovery, and radiosurgery usually takes 1 day. Gamma Knife has submillimeter stereotactic accuracy, which allows to achieve good control over tumor growth. There are no relapses, complications are minimal, and mortality is zero.
Radiosurgery can also be successfully used in patients who suffer from recurrence of tumors after radiation therapy. Today, this method is a priority not only for the treatment of residual and recurrent neoplasms, but also as primary therapy.
Forecast
If the diagnosis was made early, and the tumor was removed in a timely manner, then the prognosis of the outcome of the treatment of the disease becomes favorable. The functions of the middle ear are fully restored.