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) |
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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 - Jun 2012 |
Keywords
- Glomus jugulare
- Lateral skull base
- Paraganglioma
ASJC Scopus subject areas
- Clinical Neurology