What are the typical radiological findings of a glomus jugulare tumor on computed tomography (CT) scans, magnetic resonance imaging (MRI), and angiography?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: February 4, 2026 • View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Radiological Findings of Glomus Jugulare

High-resolution CT temporal bone demonstrates irregular lytic bone destruction with enlargement of the jugular foramen, while MRI with contrast reveals a hypervascular soft tissue mass with characteristic "salt-and-pepper" appearance, and angiography shows intense tumor blush supplied predominantly by the ascending pharyngeal artery. 1

CT Temporal Bone Findings

Osseous Changes

  • Irregular lytic bone destruction with enlargement of the jugular foramen is the hallmark CT finding that distinguishes glomus jugulare from benign lesions like schwannomas, which show smooth, well-defined bone margins 1
  • CT demonstrates superior sensitivity (87.5%) for detecting hypoglossal canal invasion compared to MRI, making it essential for surgical planning 2
  • Thin-cut high-resolution bone windows through the posterior skull base are required to adequately assess the extent of bony involvement 2

Key Distinguishing Features

  • Unlike glomus tympanicum (which shows soft tissue on the promontory without bone erosion), glomus jugulare demonstrates frank erosion of the jugular foramen and often the carotid canal 3
  • The bony reconstructions from CTA can provide excellent osseous detail and may be more accurate than MRI for diagnosing glomus jugulare in some studies 2

MRI Findings

Soft Tissue Characterization

  • MRI with contrast is essential for evaluating the full extent of glomus jugulare, particularly intracranial extension and involvement of adjacent soft tissue structures 3
  • MRI demonstrates 100% sensitivity for detecting hypoglossal canal invasion, though with lower specificity (59%) compared to CT 2
  • The improved soft tissue contrast allows assessment of the brainstem, intracranial nerve segments, and extracranial nerve course 2

Vascular Assessment

  • MRA with contrast can detect larger glomus jugulare tumors and assess intracranial vascular involvement 3
  • MRI reveals vascular and soft tissue structures to best advantage compared to CT 1

Angiographic Findings

Vascular Supply Pattern

  • The inferior tympanic artery (branch of the ascending pharyngeal artery) provides the dominant blood supply to glomus jugulare tumors 3
  • Angiography demonstrates a hypervascular lesion with intense tumor blush supplied by numerous small branches of the external carotid artery system 4
  • Tumors may receive supplementary blood supply from clival branches of the internal carotid artery when extending around the carotid canal 3

Pre-procedural Mapping Requirements

  • Selective catheterization of both external and internal carotid branches is required to adequately delineate the complete blood supply 3
  • Superselective catheterization of external carotid branches confirms blood supply and reveals dangerous intracranial anastomoses that must be identified before embolization 3
  • Evaluation of contralateral carotid branches is necessary to exclude contribution to tumor blush, particularly when tumor crosses midline 3
  • Digital subtraction angiography allows identification of displaced feeders, facilitating their localization for potential surgical ligation 3

Imaging Protocol Recommendations

First-Line Imaging

  • CTA head and neck with IV contrast is the imaging modality of choice because it demonstrates both arterial and venous pathologies while providing excellent bony detail from thin-section reconstructions 2
  • CTA has combined sensitivity and specificity of 90% for detecting vascular pathology and can diagnose glomus jugulare more accurately than MRI in some studies 2

Complementary Studies

  • High-resolution CT temporal bone without contrast provides superior osseous detail but cannot assess vascular abnormalities 2
  • MRI with contrast serves as the confirmatory study and is essential for evaluating intracranial extension 3

Critical Clinical Pitfalls

Biopsy Contraindication

  • Never perform biopsy of suspected glomus tumors due to risk of devastating hemorrhagic complications—imaging alone establishes the diagnosis 3
  • Several non-paraganglioma lesions (hemangiopericytoma, extramedullary plasmacytoma, giant cell tumors) can mimic glomus jugulare in clinical and radiographic presentation, but the hypervascularity visible on imaging should preclude blind biopsy 4, 5

Persistent Tumor After Treatment

  • Post-irradiation angiography may show persistent tumor vessels and abnormal channels, as radiotherapy does not always achieve permanent tumor eradication 6
  • Histologic studies demonstrate that tumor cells persist after radiation treatment in a significant proportion of patients 6

References

2
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Guideline

Glomus Tympanicum Tumor Characteristics

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

4
Research

Giant cell tumors of the jugular foramen.

American journal of otolaryngology, 1999

Related Questions

What is the preferred treatment, Domperidone (prokinetic agent) or Ondansetron (antiemetic), for a patient with nausea and vomiting due to gastrointestinal disorders, such as gastroparesis, or chemotherapy/radiation therapy?
What is the explanation and rationale for using special maneuvers like Scarf, Yocum, Hawkin's Kennedy, Neer, Empty can, Lift Off, Yergason, and Speed's test in patients with shoulder pain or limited mobility, particularly those with a history of shoulder injuries or physically demanding occupations?
What triggers mastoiditis, particularly in children or adults with a weakened immune system or underlying health conditions such as diabetes or HIV/AIDS?
What are the guidelines for managing meningitis in an immunocompromised adult patient with a history of disseminated varicella and steroid use?
What approach should be taken for a patient with psychiatric conditions, diabetes, opioid use disorder, and respiratory issues, on Risperidone, Lamotrigine, Suboxone, Doxepin, Gabapentin, Metformin, Albuterol, and Seroquel?
What is the recommended treatment approach for a patient suspected of having meningitis?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.

Ask Question