Malignant glomus tumors

Objectives/Hypothesis: To ascertain the incidence of malignancy in a large glomus and skull base series and to compare the clinical course of such pat ients with those who do not have malignant skull base lesions. Study Design : Retrospective review of all skull base surgery cases treated at the Otolo gy Group between 1970 and 1995. Results: In a series of 175 jugulotympanic glomus tumors, 9 cases (5.1%) mere identified. The surgery required for the ir extirpation is more extensive than nonmalignant glomus tumors. Attendant deficits and mortality from these procedures are accordingly greater. Five -year survival in this limited population was 72%. Prolonged periods of sur vival are possible with distant metastases. Conclusions: This rate of malig nancy should advocate against a watchful, waiting approach. Radiation thera py is not advocated as a primary modality for this type of tumor, as it may lead to recurrence/persistence with either subsequent malignant degenerati on and metastases or local recurrence.