Stereotactic radiosurgery for the treatment of Glomus Jugulare Tumors

Abstract

Background:The glomus jugulare tumor is a slowly growing benign neoplasm originating from neural crest. There is a high morbidity associated with surgical resection of glomus jugulare. Radiosurgery play a relevant role as a therapeutic option in these tumors and its use has grown in popularity. The authors describe a retrospective series of 15 patients and reviewed the literature about the glomus jugulare tumors.Methods:We reviewed retrospectively the data of 15 patients treated with stereotactic linear accelerator stereotactic radiosurgery (LINAC) radiosurgery between 2006 and 2011.Results:The average tumor volume was 18.5 cm3. The radiation dose to the tumor margin ranged between 12 and 20 Gy. The neurological status improved in three patients and remained unchanged in 12 patients. One patient developed a transient 7th nerve palsy that improved after clinical treatment. All tumors remained stable in size on follow-up with resonance magnetic images.Conclusions:The radiosurgery is a safe and effective therapy for patients with glomus jugulare tumor. Despite the short follow-up period and the limited number of patients analyzed, we can infer that radiosurgery produce a tumor growth control with low morbidity, and may be used as a good option to surgical resection in selected cases.

Leksell Gamma Knife radiosurgery of the jugulotympanic glomus tumor: long-term results

“…The morbidity associated with radiosurgery in our series and also in other reported series 1,[3][4][5][6][7]9,13,[15][16][17][18][19][20]23,24 was low, nondisabling, and usually temporary. There was no mortality associated with treatment of the glomus tumor itself.…”

“…However, in the published series, it is not possible to evaluate the long-term effectiveness of radiosurgery on slowly growing tumors from paraganglia because only short-term or midterm follow-up has been reported to date ( Table 2). 1,[3][4][5][6][7]9,13,[15][16][17][18][19][20]23,24 The largest published series represents a multicenter study involving the treatment of 132 patients. 20 The authors of this retrospective study of 8 Gamma Knife centers assessed 132 patients in a median follow-up period of 50.5 months.…”

Microsurgical treatment of large and giant tympanojugular paragangliomas

“…[ 25 ] Recent studies have explored radiosurgery for TJP as a primary treatment. [ 2 4 11 14 15 16 17 18 24 26 45 ] The beneficial effects of radiosurgery are comparable to their application on cerebral arteriovenous malformations. The precise stereotactic localization and the combined steep dose gradient outside the target volume allow the application of a large single doses to a precisely defined lesion.…”

“…The precise stereotactic localization and the combined steep dose gradient outside the target volume allow the application of a large single doses to a precisely defined lesion. [ 2 14 ] While radiosurgery alone is appropriate for smaller tumors, in larger tumors, especially, the potential risks of wide field radiation are still major concerns. Stereotactic radiosurgery revealed high rates of tumor growth control and relatively low morbidity in recent series.…”

“…Fractionated radiotherapy, stereotactic radiosurgery, gamma knife radiosurgery, and cyberknife radiosurgery as the primary treatment revealed high rates of tumor growth control and relatively low morbidity in recent series. [ 2 4 11 14 15 16 17 18 19 24 26 45 ] Surgery for large TJP is challenging due to their high vascularity and close relationship with delicate neural and vascular structures. [ 1 27 39 ] However, favorable long-term results can be achieved by combining surgical expertise from specialized neurosurgeons, ENT surgeons, and interventional neuroradiologists in the planning and execution of surgery.…”