[A new strategy for the treatment of jugular foramen tumors using radiosurgery]

A new treatment strategy for jugular foramen tumors using radiosurgery is reported. Six jugular foramen tumors, including 2 glomus tumors and 4 lower cranial neurinomas, were involved. Among them only one tumor was confined in the jugular foramen, but the others extended into the posterior fossa, the upper cervical portion or both. As an initial treatment, 3 cases underwent operative resection from suboccipital or transcervical route. The tumor sizes at radiosurgery ranged from 14.3 to 36.1 mm with a mean of 22.4 mm in diameter. They were treated with a marginal dose between 13 to 16.5 Gy (mean 15.6 Gy). Follow-up MRI showed an apparent tumor shrinkage in 4 and no change in 2. Central tumor necrosis was found in 4 cases, but tumor progression was never observed in the mean follow-up period of 19 months. No complication occurred during and after the radiosurgery. These results indicate that radiosurgery is effective for the control of jugular foramen tumors with acceptable risk. Large tumors extending to the upper cervical portion and posterior fossa can be treated by operative resection combined with radiosurgery.