Glomus Jugulare Tumors

Neurosurgery - Tập 59 Số 3 - Trang 561-569 - 2006
Massimo Gerosa1, A Visca1, Paolo Boscolo‐Rizzo1, Roberto Foroni1, A. Nicolato1, Albino Bricolo1
1Department of Neurosurgery, University Hospital, Verona, Italy

Tóm tắt

Abstract OBJECTIVE: Glomus jugulare tumors are generally considered slow-growing, benign lesions. However, their pronounced local aggressiveness frequently results in severe neurological deficits. Surgical removal is rarely radical and is usually associated with morbidity. There is increasing evidence that stereotactic radiosurgery, particularly gamma knife radiosurgery (GKR), may play a relevant role as a therapeutic option in these tumors. METHODS: Between 1996 and 2005, we used GKR to treat 20 patients bearing growing glomus jugulare tumors, mostly classified as Glasscock-Jackson Grade IV or Fisch Stage D1. Follow-up (mean, 50.85 mo) data was available for 20 patients (four men, 16 women; mean age, 56 yr): eight out of 20 tumors were surgical recurrences, three out of 20 patients had GKR as the primary treatment, and 11 out of 20 patients previously underwent endovascular embolization. Regarding the radiosurgical dose planning, the average tumor volume was 7.03 cm3 (range, 1.5–13.4 cm3) and the mean marginal dose was 17.3 Gy (range, 13–24 Gy). RESULTS: Neurological signs and symptoms were unchanged in 13 out of 20 patients. An improvement of cranial nerve function was observed in five patients and hearing deterioration was observed in two patients. Tumor volume was unchanged in 11 out of 20 patients and was slightly (≤ 20%) decreased in eight out of 20 patients. In one unusual case of a bulky cavernous sinus recurrence, neoplastic regression was particularly pronounced. CONCLUSION: Despite the constraints of the limited case material, considering the estimated doubling time of these rare tumors (4.2 yr), our preliminary results with GKR at a mid-term follow-up examination suggest an effective tumor growth control with negligible incidence of untoward sequelae.

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Tài liệu tham khảo

Al-Mefty, 2002, Complex tumors of the glomus jugulare: Criteria, treatment, and outcome, J Neurosurg, 97, 1356, 10.3171/jns.2002.97.6.1356

Anand, Neurovascular considerations in surgery of glomus tumors with intracranial extensions, Laryngoscope 103 [Suppl 60], 722

Bojrab, 1992, Management of metastatic glomus jugulare tumors, Skull Base Surgery, 2, 1, 10.1055/s-2008-1057105

Boyle, 1990, Radiation therapy for paragangliomas of the temporal bone, Laryngoscope, 100, 896, 10.1288/00005537-199008000-00018

Briner, 1999, Long-term results of surgery for temporal bone paragangliomas, Laryngoscope, 109, 577, 10.1097/00005537-199904000-00011

Brown, 1985, Glomus jugulare tumors rivisited: A ten-year statistical follow-up of 231 cases, Laryngoscope, 95, 284, 10.1288/00005537-198503000-00008

Carrasco, Radiation therapy of glomus jugulare tumors, Laryngoscope 103 [Suppl 60], 23

Cole, 1994, Long-term results of treatment for glomus jugulare and glomus vagale tumors with radiotherapy, Laryngoscope, 104, 1461, 10.1288/00005537-199412000-00006

De Jong, 1995, Radiation therapy in the management of paragangliomas of the temporal bone, Am J Otolaryngol, 16, 283

Elshaik, 2002, Recurrent head-and-neck chemodectomas: A comparison of surgical and radiotherapeutic results, Int J Radiation Oncol Biol Phys, 52, 955

Eustacchio, 2002, The role of Gamma Knife Radiosurgery in the managementof glomus jugulare tumors, Acta Neurochir Suppl (Wien), 84, 91

Farrior, 1980, Carcinoid apudomas arising in a glomus jugulare tumor: Review of endocrine activity in glomus jugulare tumors, Laryngoscope, 90, 110, 10.1288/00005537-198001000-00013

Foote, 2002, Glomus jugulare tumor: Tumor control and complications after stereotactic radiosurgery, Head Neck, 24, 332, 10.1002/hed.10005

Gabriel, 1995, Glomus jugulare tumor metastatic to the sacrum after high-dose radiation therapy: Case report, Neurosurgery, 37, 1001, 10.1227/00006123-199511000-00022

Gjuric, 1996, Long-term results of surgery for temporal bone paraganglioma, Skull Base Surg, 6, 147, 10.1055/s-2008-1058638

Glasscock, 1979, Panel discussion: Glomus jugulare tumors of the temporal bone, The surgical management of glomus tumors. Laryngoscope, 89, 1640

Green, 1994, Surgical management of previously untreated glomus jugulare tumors, Laryngoscope, 104, 917, 10.1288/00005537-199408000-00001

Gstoettner, 1999, Long-term results of different treatment modalities in 37 patients with glomus jugulare tumors, Eur Arch Otorhinolaryngol, 256, 350, 10.1007/s004050050162

Gulya, 1993, The glomus tumor and its biology, Laryngoscope, 103, 7, 10.1002/lary.1993.103.s60.7

Jansen, 2000, Estimation of growth rate in patients with head and neck paragangliomas influences the treatment proposal, Cancer, 88, 2811, 10.1002/1097-0142(20000615)88:12<2811::AID-CNCR21>3.0.CO;2-7

Johnston, 1992, Malignant paraganglioma of the glomus jugulare: A case report, Br J Neurosurg, 6, 255, 10.3109/02688699209002935

Jordan, 2000, Stereotactic radiosurgery for glomus jugulare tumors, Laryngoscope, 110, 35, 10.1097/00005537-200001000-00007

Lalwani, 1993, Lethal fibrosarcoma complicating radiation therapy for benign glomus jugulare tumors, Am J Otol, 14, 398

Larner, 1992, Glomus jugulare tumors, Long-term control by radiation therapy. Cancer, 69, 1813

LaRouere, 1994, Selective embolization of glomus jugulare tumors, Skull Base Surg, 4, 21, 10.1055/s-2008-1058984

Linskey, 2003, Radiation exposure of the normal temporal bone structures during stereotactically guided gamma knife surgery for vestibular schwannomas, J Neurosurg, 98, 800, 10.3171/jns.2003.98.4.0800

Liscak, 1999, Gamma Knife Radiosurgery of the Glomus Jugulare Tumour: Early Multicentre Experience, Acta Neurochir (Wien), 141, 1141, 10.1007/s007010050411

Maarouf, 2003, Stereotactic Linear Accelerate-Based Radiosurgery for the Treatment of Patients with Glomus Jugulare Tumors, Cancer, 97, 1093, 10.1002/cncr.11118

Mikherji, 1994, Irradiated paragangliomas of the head and neck: CT and MR appearance, AJNR Am J Neuroradiol, 15, 357

Netterville, 1995, Carotid body tumors: A review of 30 patients with 46 tumors, Laryngoscope, 105, 115, 10.1288/00005537-199502000-00002

Order, 1968, Improvement in quality of survival following whole-brain irradiation for brain metastasis, Radiology, 91, 149, 10.1148/91.1.149

Patel, 1994, Combined approaches for resection of extensive glomus jugulare tumours, J Neurosurg, 80, 1026, 10.3171/jns.1994.80.6.1026

Pauw, 1993, Preoperative embolization of paragangliomas (glomus tumors) of the head and neck: Histopathologic and clinical features, Skull Base Surg, 3, 37, 10.1055/s-2008-1060563

Saringer, 2001, Efficiency of gamma knife radiosurgery in the treatment of glomus jugulare tumors, Minim Invasive Neurosurg, 44, 141, 10.1055/s-2001-18162

Schild, 1992, Results of radiotherapy for chemodectomas, Mayo Clin Proc, 67, 537, 10.1016/S0025-6196(12)60460-1

Sheehan, 2005, Gamma knife surgery for glomus jugulare tumors: An intermediate report on efficacy and safety, J Neurosurg (Suppl), 102, 241, 10.3171/sup.2005.102.s_supplement.0241

Springate, 1991, Temporal bone chemodectomas: Comparing surgery and radiation therapy, Oncology (Huntington), 5, 131

Thedinger, 1992, Postoperative radiographic evaluation after acoustic neuroma and glomus jugulare tumor removal, Laryngoscope, 102, 261, 10.1288/00005537-199203000-00006

van Der Mey, 1992, Does intervention improve the natural course of glomus tumours?, Ann Otol Rhinol Laryngol, 635

Watkins, 1994, Glomus jugulare tumours: A review of 61 cases, Acta Neurochir (Wien), 130, 66, 10.1007/BF01405504

Willen, Treatment of glomus jugulare tumors in patients with advanced age: Planned limited surgical resection followed by staged gamma knife radiosurgery: a preliminary report, Otol Neurotol 26, 1229

Woods, Surgery for Glomus Tumors: The otology group experience, Laryngoscope 103 [Suppl 60], 65

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Neurosurgery

Tập 59 Số 3

561-569

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