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Radiosurgery for the control of glomus jugulare tumours
M E Bari1, A A Kemeny, D M C Forster
1Department of Neurosurgery, Aga Khan University Hospital, Karachi.
Objective:
To ascertain the efficacy of stereotactic radiosurgery (gamma knife) for the control of glomus jugulare tumours.
Method:
Between March 1994 and December 1997 we treated eight patients of glomus jugulare tumour with radiosurgery. These patients have been followed for more than four years (range 52 to 97 months). The age of the patients ranged between 32-64 years (mean 53 years). The male: female ratio was 3:5. Three patients had previously undergone surgery and one had unsuccessful embolization. The dose applied to tumour margin ranged between 16-25 Gy (median 25 Gy). Patients were followed up with yearly MRI scans and where possible with cerebral angiography.
Results:
All patients showed stabilisation of their symptoms following radiosurgery and six improved clinically. Five of these patients showed decrease in the size of lesion seen objectively on radiology, either slight to moderate decrease seen on the MRI scan or reduction in size and vascularity seen on cerebral angiography. The procedure is minimally invasive and none of the patients showed any adverse effect to radiosurgery.
Conclusion:
These results are encouraging but because of its naturally slow growth rate, up to 10 years of follow up will be necessary to establish a cure rate after radiosurgery for these lesions.