Surgical management of giant transdural glomus jugulare tumors with cerebellar and brainstem compression

Matthew L. Carlson, Colin L.W. Driscoll, Joaquin J. Garcia, Jeffrey R. Janus, Michael J. Link

Research output: Contribution to journalArticle

8 Scopus citations

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 languageEnglish (US)
Pages (from-to)197-207
Number of pages11
JournalJournal of Neurological Surgery, Part B: Skull Base
Volume73
Issue number3
DOIs
StatePublished - Jun 2012

Keywords

  • Glomus jugulare
  • Lateral skull base
  • Paraganglioma

ASJC Scopus subject areas

  • Clinical Neurology

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