Otology: glomus tumour: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Otology: glomus tumour

Sample item

A 50-year-old woman has pulsatile tinnitus that stops on compression of the ipsilateral carotid, and conductive hearing loss. Otoscopy shows a red, vascular mass behind an intact tympanic membrane that blanches on pneumatic pressure. What is the diagnosis, and why should a biopsy through the drum be avoided?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Glomus tympanicum (paraganglioma), because the lesion is highly vascular and may bleed profusely

Glomus tumours are paragangliomas that arise from glomus bodies in the middle ear (tympanicum) or at the jugular bulb (jugulare). They cause pulsatile tinnitus and conductive loss, and appear as a red 'rising sun' mass behind the drum that blanches on positive pressure (Brown sign). They are highly vascular, so biopsy risks severe haemorrhage. Diagnosis is by CT and MRI with angiography, and treatment is surgery or radiotherapy, and catecholamine secretion is excluded.

Option by option

  • A. Glomus tympanicum (paraganglioma), because the lesion is highly vascular and may bleed profusely (correct)

    Correct. A pulsatile vascular mass behind the drum is a glomus tumour, and biopsy risks brisk bleeding.

  • B. Otosclerosis, because it may cause facial palsy

    Otosclerosis may give a pink 'Schwartze sign' through the drum, but not a pulsatile vascular mass.

  • C. Acoustic neuroma, because it may seed the cerebrospinal fluid

    Acoustic neuroma causes sensorineural loss and is not visible on otoscopy.

  • D. Cholesteatoma, because it may spread

    Cholesteatoma appears as a white keratin mass in a retraction pocket and is not pulsatile.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this ENT question

What is the answer to this ENT question?

The best answer is A, Glomus tympanicum (paraganglioma), because the lesion is highly vascular and may bleed profusely. Glomus tumours are paragangliomas that arise from glomus bodies in the middle ear (tympanicum) or at the jugular bulb (jugulare).

Why is "Otosclerosis, because it may cause facial palsy" not the answer?

Otosclerosis may give a pink 'Schwartze sign' through the drum, but not a pulsatile vascular mass.

Why is "Acoustic neuroma, because it may seed the cerebrospinal fluid" not the answer?

Acoustic neuroma causes sensorineural loss and is not visible on otoscopy.

Why is "Cholesteatoma, because it may spread" not the answer?

Cholesteatoma appears as a white keratin mass in a retraction pocket and is not pulsatile.

What concept does this question test?

It tests Otology: glomus tumour in ENT. They cause pulsatile tinnitus and conductive loss, and appear as a red 'rising sun' mass behind the drum that blanches on positive pressure (Brown sign). They are highly vascular, so biopsy risks severe haemorrhage. Diagnosis is by CT and MRI with angiography, and treatment is surgery or radiotherapy, and catecholamine secretion is excluded.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Otology: glomus tumour?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.