title: Nonglomic tumors of the jugular foramen: differential diagnosis and prognostic implications.
abstract: OBJECTIVE
  Tumors of the jugular foramen are notably rare, and the majority of them arise from the glomic tissue of the jugular vein. There are other tumors that do not originate from that tissue, and these are called the nonglomic tumors. This report includes a series of patients with nonglomic tumors of the jugular foramen to analyze their biological and radiological behavior and the clinical outcomes of patients.
  
  
  METHODS
  Patients with tumors of the jugular foramen other than chemodectomas were included for the present series. All of the patients were subjected to a protocol that included imaging studies and a complete clinical evaluation. Surgery was planned and performed by a multidisciplinary team using the following approaches: retrosigmoid, infratemporal fossa, and zygomatic-transmandibular. Depending on the precise diagnosis and surgical outcomes, radiotherapy or radiosurgery were indicated. The average follow-up period was 5 years.
  
  
  RESULTS
  Thirty patients with nonglomic tumors were included: 18 schwannomas, 6 meningiomas, 5 chordomas, and 1 metastatic carcinoma. The patients with chordomas had the most severe clinical manifestations, and the chordomas were the largest and most invasive tumors that destroyed the jugular foramen contour on imaging studies. Schwannomas presented a more benign clinical evolution and enlarged (but did not destroy) the jugular foramen contour. Two patients died (chordomas) during the follow-up because of tumor activity.
  
  
  CONCLUSIONS
  The most common nonglomic tumor of the jugular foramen was the schwannoma, which was the lesion with the best surgical prognosis. Chordoma is a rare and highly destructive tumor that has a notably high recurrence index.
authors.affiliation: Department of Neurosurgery, Hospital de Especialidades del Centro Medico Nacional Siglo XXI, Mexico City, Mexico; Centro Neurologico ABC, Mexico City, Mexico. Electronic address: gguinto@prodigy.net.mx.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Guinto
authors.affiliation: Department of Otolaryngology, Hospital de Especialidades del Centro Medico Nacional Siglo XXI, Mexico City, Mexico.
authors.forename: Miguel
authors.initials: M
authors.lastname: Kageyama
authors.affiliation: Department of Neurosurgery, Hospital de Especialidades del Centro Medico Nacional Siglo XXI, Mexico City, Mexico.
authors.forename: Víctor H
authors.initials: VH
authors.lastname: Trujillo-Luarca
authors.affiliation: Department of Neurosurgery, Hospital de Especialidades del Centro Medico Nacional Siglo XXI, Mexico City, Mexico.
authors.forename: Miguel
authors.initials: M
authors.lastname: Abdo
authors.affiliation: Department of Neurosurgery, Hospital de Especialidades del Centro Medico Nacional Siglo XXI, Mexico City, Mexico.
authors.forename: Alberto
authors.initials: A
authors.lastname: Ruiz-Than
authors.affiliation: Department of Neurosurgery, Hospital de Especialidades del Centro Medico Nacional Siglo XXI, Mexico City, Mexico.
authors.forename: Alberto
authors.initials: A
authors.lastname: Romero-Rangel
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005925:Glomus Jugulare Tumor / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Approach; Infratemporal fossa; Jugular foramen; Nonglomic tumors; Skull base surgery