Perioperative Management of Catecholamine-Secreting Glomus Jugulare Tumors

• Main Authors: Yu Teranishi, Michihiro Kohno, Shigeo Sora, Hiroaki Sato, Naoko Haruyama
• Format: Article
• Language: English
• Published: Georg Thieme Verlag KG 2014-06-01
• Series: Journal of Neurological Surgery Reports
• Subjects: glomus jugular tumor; pheochromocytoma; catecholamine; surgical strategy; skull base surgery
• Online Access: http://www.thieme-connect.de/DOI/DOI?10.1055/s-0034-1378154

Abstract To treat patients with a catecholamine-secreting glomus jugulare tumor, perioperative management is important. Perioperative catecholamine hypersecretion causes severe problems in the treatment of a catecholamine-secreting glomus tumor. Therefore, a precise therapeutic strategy and perioperative management are required through collaboration of the endocrinology, anesthesiology, and endocrine surgery departments . We describe our perioperative management for catecholamine-secreting glomus jugulare tumor. The patient was a 31-year-old woman with a 50-mm glomus jugulare tumor and a significantly elevated plasma noradrenaline level of 21,165 pg/ml. Before the surgery, oral α − blocker administration was initiated for ∼ 3 months, and her body weight increased from 52 kg at the time of examination to 54.2 kg. Coil embolization of the tumor vessel was performed 1 week before surgery, and the intense tumor stain was reduced by 90%. The patient underwent almost total removal of the tumor via mastoidectomy with high cervical exposure via the transsigmoid approach. Postoperatively, plasma noradrenaline decreased markedly. Preoperative pharmacologic stabilization and peri- and postoperative anesthetic management are essential for the treatment of a catecholamine-secreting glomus jugulare tumor.