SFEBES2009 Poster Presentations Endocrine tumours and neoplasia (39 abstracts)
Secretory glomus jugulare tumour treated with steriotactic radio surgery
R N Kulambil Padinjakara , Subash Sivaraman , David Dutton , N P N Murthy , Martin Weickert , Ateeq Sayed , Harpal Randeva & Sailesh Shankar
University Hospital of Coventry and Warwickshire, Coventry, UK.
Glomus jugulare tumours are rare and often difficult to manage. A small proportion of these tumours (1–3%) can cause symptoms due to catecholamine secretion. Here we describe a patient with secretory glomus jugulare tumour treated with steriotactic radio surgery and its effect on catecholamine secretion.
Case report: A 39-year-old lady was referred to ear specialists with the characteristic symptoms of pulsatile tinnitus and decreased hearing in the left ear. Clinical diagnosis of a left sided glomus tumour was later confirmed with an MRI scan of the skull base which showed a dumbbell shaped avidly-enhancing 32 mm×19 mm lesion of the jugular fossa with intra cranial and middle ear extensions. A 24 h collection of urine showed elevated noradrenaline excretion (3370 nmol/collection) with normal adrenaline and dopamine excretion. She did not have any symptoms pertaining to catecholamine excess. Genetic analysis confirmed deletion of exon 6 of SDHC gene. She underwent steriotactic radio surgery following which her urinary noradrenaline secretion was reduced by more than 50%. Subsequent MRI did not show further of the growth of the tumour.
Discussion: Steriotactic radio surgery is now an established treatment option for glomus jugulare tumours and has shown to arrest tumour growth and improve symptoms. This case reports illustrates that it could improve endocrine secretory problems as well and add to valuable information to the evidence base for management of these rare tumours.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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