Gamma knife radiosurgery in jugular foramen endolymphatic sac adenocarcinoma

A 41-year-old male presented to us with a history of right-sided temporal headache and ear discharge. MRI revealed an extra-axial space-occupying lesion in the region of the right jugular foramen. The patient was operated upon and a radical excision of the tumor was performed. Histopathology revealed an adenocarcinoma, probably of endolymphatic sac origin. The patient had a recurrence of tumor at 2-year follow-up and was subjected to gamma knife radiosurgery. The patient was subsequently asymptomatic at a 2.5-year follow-up and imaging revealed regression of the tumor size. Stereotactic radiosurgery in recurrent endolymphatic sac tumors involving the jugular foramen has not been reported previously. We review the literature on this novel treatment protocol for this rare skull base tumor.