Abstract
Objective: The objective of this study is to discuss the management of advanced glomus jugulare tumors (GJTs) presenting with intradural disease and concurrent brainstem compression. Study Design: This is a retrospective case series. Results: Over the last decade, four patients presented to our institution with large (Fisch D2; Glasscock-Jackson 4) primary or recurrent GJTs resulting in brainstem compression of varying severities. All patients underwent surgical resection through a transtemporal, transcervical approach resulting in adequate brainstem decompression; the average operative time was 12.75 hours and the estimated blood loss was 2.7 L. All four patients received postoperative adjuvant radiotherapy in the form of intensity-modulated radiation therapy or stereotactic radiosurgery. Combined modality treatment permitted tumor control in all patients (range of follow-up 5 to 9 years). Conclusion: A small subset of GJTs may present with intracranial transdural extension with aggressive brainstem compression mandating surgical intervention. Surgical resection is extremely challenging; the surgical team must be prepared for extensive operating time and the patient for prolonged aggressive rehabilitation. Newly diagnosed and recurrent large GJTs involving the brainstem may be controlled with a combination of aggressive surgical resection and postoperative radiation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 197-207 |
| Number of pages | 11 |
| Journal | Journal of Neurological Surgery, Part B: Skull Base |
| Volume | 73 |
| Issue number | 3 |
| DOIs | |
| State | Published - 2012 |
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Keywords
- Glomus jugulare
- Lateral skull base
- Paraganglioma
ASJC Scopus subject areas
- Clinical Neurology
Cite this
Surgical management of giant transdural glomus jugulare tumors with cerebellar and brainstem compression. / Carlson, Matthew L.; Driscoll, Colin L.W.; Garcia, Joaquin J.; Janus, Jeffrey R.; Link, Michael J.
In: Journal of Neurological Surgery, Part B: Skull Base, Vol. 73, No. 3, 2012, p. 197-207.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Surgical management of giant transdural glomus jugulare tumors with cerebellar and brainstem compression
AU - Carlson, Matthew L.
AU - Driscoll, Colin L.W.
AU - Garcia, Joaquin J.
AU - Janus, Jeffrey R.
AU - Link, Michael J.
PY - 2012
Y1 - 2012
N2 - Objective: The objective of this study is to discuss the management of advanced glomus jugulare tumors (GJTs) presenting with intradural disease and concurrent brainstem compression. Study Design: This is a retrospective case series. Results: Over the last decade, four patients presented to our institution with large (Fisch D2; Glasscock-Jackson 4) primary or recurrent GJTs resulting in brainstem compression of varying severities. All patients underwent surgical resection through a transtemporal, transcervical approach resulting in adequate brainstem decompression; the average operative time was 12.75 hours and the estimated blood loss was 2.7 L. All four patients received postoperative adjuvant radiotherapy in the form of intensity-modulated radiation therapy or stereotactic radiosurgery. Combined modality treatment permitted tumor control in all patients (range of follow-up 5 to 9 years). Conclusion: A small subset of GJTs may present with intracranial transdural extension with aggressive brainstem compression mandating surgical intervention. Surgical resection is extremely challenging; the surgical team must be prepared for extensive operating time and the patient for prolonged aggressive rehabilitation. Newly diagnosed and recurrent large GJTs involving the brainstem may be controlled with a combination of aggressive surgical resection and postoperative radiation.
AB - Objective: The objective of this study is to discuss the management of advanced glomus jugulare tumors (GJTs) presenting with intradural disease and concurrent brainstem compression. Study Design: This is a retrospective case series. Results: Over the last decade, four patients presented to our institution with large (Fisch D2; Glasscock-Jackson 4) primary or recurrent GJTs resulting in brainstem compression of varying severities. All patients underwent surgical resection through a transtemporal, transcervical approach resulting in adequate brainstem decompression; the average operative time was 12.75 hours and the estimated blood loss was 2.7 L. All four patients received postoperative adjuvant radiotherapy in the form of intensity-modulated radiation therapy or stereotactic radiosurgery. Combined modality treatment permitted tumor control in all patients (range of follow-up 5 to 9 years). Conclusion: A small subset of GJTs may present with intracranial transdural extension with aggressive brainstem compression mandating surgical intervention. Surgical resection is extremely challenging; the surgical team must be prepared for extensive operating time and the patient for prolonged aggressive rehabilitation. Newly diagnosed and recurrent large GJTs involving the brainstem may be controlled with a combination of aggressive surgical resection and postoperative radiation.
KW - Glomus jugulare
KW - Lateral skull base
KW - Paraganglioma
UR - http://www.scopus.com/inward/record.url?scp=84904283596&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84904283596&partnerID=8YFLogxK
U2 - 10.1055/s-0032-1312707
DO - 10.1055/s-0032-1312707
M3 - Article
VL - 73
SP - 197
EP - 207
JO - Journal of Neurological Surgery, Part B: Skull Base
JF - Journal of Neurological Surgery, Part B: Skull Base
SN - 2193-6331
IS - 3
ER -