Glomus tumors and paragangliomas in neurological practice: clinical mimics, diagnostic pitfalls, and strategies for overcoming them

Abstract

Optimizing the diagnosis of glomus tumors necessitates a clear distinction between two principal nosological entities. The true glomus tumor (glоmangioma) is pathognomonically associated with intense paroxysmal pain. In contrast, paraganglioma (chemodectoma) most frequently presents with compression of adjacent structures, accompanied by pulsatile tinnitus. All paragangliomas should be regarded as potentially malignant, underscoring the need for long-term follow-up. The diagnostic algorithm must be comprehensive and should sequentially include detailed clinical assessment, mandatory contrast-enhanced magnetic resonance imaging, and in cases of suspected paraganglioma, biochemical screening and molecular genetic testing. Overcoming diagnostic challenges and ensuring early recognition hinge crucially on raising neurologists’ awareness of the clinical polymorphism of these entities, actively incorporating them into the differential diagnosis, and the timely application of advanced instrumental investigations to facilitate appropriate treatment planning.