Biochemical and clinical responses after treatment of a catecholamine-secreting glomus jugulare tumor with gamma knife radiosurgery.
BACKGROUND
Functional glomus jugulare tumors (GJTs) are commonly managed with resection. Although primary radiation therapy of functional GJT can provide durable control of tumor growth, little is known of its ability to ablate functional capacity.


RESULTS
We describe a case of a 47-year-old man with a symptomatic norepinephrine-hypersecreting GJT treated with definitive single-fraction gamma knife radiosurgery and pharmacologic catecholamine blockade. At a 32-month follow-up, he has experienced significant symptomatic improvement, excellent control of local tumor growth, minimal treatment-related morbidity, and near normalization of catecholamine levels.


CONCLUSIONS
Radiosurgery was safe and effective in significantly reducing the functional capacity of a paraganglioma. Care must be taken to avoid inducing a hypertensive crisis during and following treatment, and longer follow-up will help determine whether and when pharmacologic blockade can be discontinued.
Castrucci
William A
WA
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA.
Chiang
Veronica L S
VL
Hulinsky
Ilja
I
Knisely
Jonathan P S
JP
D005925:Glomus Jugulare Tumor / Q000378:metabolism / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000378:metabolism*; D016634:Radiosurgery / Q000009:adverse effects
D009638:Norepinephrine