Simultaneous Contralateral Vestibular Schwannoma and Glomus Tumor of the Temporal Bone- A Case Report

Document Type: Case Report

Authors

Department of Otolaryngology – Head and Neck Surgery and Audiology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.

Abstract

Introduction:
Presence of vestibular schwannoma and a simultaneous glomus jugulare tumor is an extremely rare event. There is only one case report regarding the incidence of a contralateral vestibular schwannoma, along with a glomus jugulare tumor. Herein, we present the second case with a contralateral tumor.
 
Case Report:
A 69-year-old woman presented with a long history of bilateral hearing loss and a 2-year history of left-sided pulsatile tinnitus. The patient also suffered the itching of the left ear canal and mild vertigo; however, she had no recollection of middle ear infection, ear discharge, or ear pain. Magnetic resonance imaging (MRI) revealed a right-sided 8-mm extrameatal vestibular schwannoma and a left-sided almost purely extracranial glomus jugulare tumor of 18 mm. The pure-tone average values were 63 and 43 dB HL for the right and left ears, respectively. Speech audiometry showed a discrimination score of 76/88 (%). Caloric irrigation was performed and revealed a unilateral weakness of 81% towards the side of vestibular schwannoma. The patient was included in a watchful waiting regimen with annual MRI scans.
 
Conclusion:
Though vestibular schwannomas and glomus jugulare tumors are pathophysiologically different, they are similar in terms of symptomatology, growth pattern, diagnostic process, and therapeutic strategy. Based on this case report, it can be concluded that a vestibular evaluation demonstrates a unilateral vestibular weakness towards the side of the vestibular schwannoma, thereby facilitating clinical discrimination between the lesions.

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