Abstract
A 38-year-old female presented asymptomatic, but with old, post-previous surgery, complete right sensorineural hearing loss, moderate right facial paresis, and mild right facial numbness. She had two prior craniotomies for glomus tumor 8 years and 4 years ago. The patient was treated with adjunctive; Linac-based SRS for regrowth of post-surgical residual, right, small size glomus jugulare tumor. The target volume of 3.8 cc received a marginal dose of 15.0 Gy normalized to 80% isodose line. Maximum dose to brain stem was 15.3 Gy. At 6 months post-SRS, the patient had improved facial numbness and worsened right facial paresis (severe). At 18 months post-SRS, the patient underwent surgical narrowing of the right palpebral fissure. At 24 months post-SRS, the patient underwent surgical anastomosis of the nerve to masseter muscle with the right facial nerve. Initial follow-up MRI showed a mild increase in tumor size and contrast enhancement. Thereafter, serial follow-up MRIs showed progressive decrease in tumor size and contrast enhancement. At last follow-up (78 months post-SRS), the patient had sustainable improvement of right-sided facial numbness and unchanged right-sided facial palsy, despite surgical nerve repair.
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Further Reading
El Majdoub F, Hunsche S, Igressa A, et al. Stereotactic LINAC-radiosurgery for glomus jugulare tumors: a long-term follow-up of 27 patients. PLoS One. 2015;10(6):e0129057. https://doi.org/10.1371/journal.pone.0129057.
Lior U, Rotem H, Uzi N, et al. LINAC radiosurgery for glomus jugulare tumors: retrospective—cohort study of 23 patients. Acta Neurochir. 2020;162(4):839–44.
Ong V, Bourcier AJ, Florence TJ, et al. Stereotactic radiosurgery for glomus jugulare tumors: systematic review and meta-analysis. World Neurosurg. 2022;163:e49–57.
Sager O, Beyzadeoglu M, Dincoglan F, et al. Evaluation of linear accelerator-based stereotactic radiosurgery in the management of glomus jugulare tumors. Tumori. 2014;100(2):184–8.
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Abdelaziz, O.S., De Salles, A.A.F. (2023). Small Size Glomus Jugulare Tumor. In: NeuroRadiosurgery: Case Review Atlas. Springer, Cham. https://doi.org/10.1007/978-3-031-16199-5_59
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DOI: https://doi.org/10.1007/978-3-031-16199-5_59
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