鼓室颈静脉球副神经节瘤误诊原因分析

Analysis of glomus jugulare-tympanicum paraganlioma: a misdiagnosed case report and literature review

摘要:

目的 探讨鼓室颈静脉球副神经节瘤的误诊原因及临床诊断和病理特点。方法 回顾性总结1例罕见鼓室颈静脉球副神经节瘤患者的临床资料，并复习相关文献，对鼓室颈静脉球副神经节瘤的临床及病理学特点进行讨论。结果 该例患者CT显示右侧外耳道、乳突气房、乳突窦及鼓室内软组织影，相应骨质吸收、破坏，结合病史，考虑慢性中耳乳突炎伴胆脂瘤形成，右侧颈静脉球高位。行耳后乳突径路切除肿瘤。术后组织病理检测诊断为鼓室颈静脉球副神经节瘤。本患者未作进一步治疗。复习文献，鼓室颈静脉球副神经节瘤较少见，临床及影像学检查无特异性，因缺乏大样本随访研究，预后不详。结论 单纯依靠症状及临床特征，鼓室颈静脉球副神经节瘤容易误诊为分泌性中耳炎或胆脂瘤，CT、MR、 DSA以及详细的组织病理学分析是诊断及鉴别鼓室颈静脉球副神经节瘤的主要方法。

Abstract:

Objective To investigate the causes of misdiagnosis, clinical diagnosis and pathological characteristics of glomus jugulare-tympanicum paraganlioma.Methods The clinical data of a rare glomus jugulare-tympanicum paraganlioma admitted to our hospital were reviewed retrospectively, and the clinical and pathological characteristics of the glomus jugulare-tympanicum paraganlioma were discussed.Results The patient’s CT showed the right external auditory canal, mastoid air chamber, mastoid sinus, and tympanic soft tissue shadows, corresponding bone resorption and destruction. Combined with medical history, and chronic middle ear mastoiditis with cholesteatoma formation was considered, and the right jugular bulb was elevated. The mass was removed by a retroauricular approach. Due to much intraoperative bleeding, the mass was not completely removed. Based on pathological examination results, the tympanic jugular paraganglioma was diagnosed. The patient has not been further treated. Reviewing the literature, glomus jugulare-tympanicum paraganlioma is rare, and the clinical and imaging examinations are not specific. Due to the lack of large sample follow-up studies, the prognosis is unknown.Conclusions Relying solely on symptoms and characteristics, glomus jugulare-tympanicum paraganlioma is easy to be misdiagnosed as secretory otitis media or cholesteatoma. The analysis of CT, MR, DSA, and detailed histopathology are the main methods for diagnosis and identification of glomus jugulare-tympanicum paraganlioma.