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.