Tympanic paraganglioma

Case contributed by Andrew Dixon
Diagnosis almost certain

Presentation

Hearing loss.

Patient Data

Age: 65 years
Gender: Male
ct

Soft-tissue density lesion within the right tympanic cavity and hypotympanum centered just anterior to the cochlear promontory. The lesion contacts the handle of the malleus. No bony erosion.  

Annotated image

Right middle ear cavity glomus tympanicum paraganglioma (red arrow) located just anterior to the cochlear promontory (blue arrow). 

Case Discussion

Right-sided middle ear soft-tissue lesion near the cochlear promontory. This lesion enhanced on MRI (not shown) is consistent with a tympanic paraganglioma (previously known as glomus tympanicum), which is the most common tumor of the middle ear cavity. These tumors can be asymptomatic, produce conductive hearing loss through contact with the ossicles (as in this case), or result in pulsatile tinnitus. This mass was observed to be stable over many years without treatment.

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