Long-term results of different treatment modalities in 37 patients with glomus jugulare tumors

The results of different forms of treatment of 37 patients with previously untreated glomus jugulare tumors were compared retrospectively. According t o the Fisch classification system, 6 patients presented with class B tumors , 19 class C and 12 patients with class D. Twenty-eight patients underwent surgery and 9 patients had primary radiation therapy (to 50 Gy). In 20 of t he surgical cases (71%), radical tumor removal could be achieved and requir ed no further treatment over a follow-up period of 8.6 years (range 2-15 ye ars). Incomplete tumor resection with postoperative radiation therapy resul ted in progressive tumor growth in three cases. One patient in this group e xperienced subarachnoid bleeding that had to be managed by salvage surgery. After primary radiation therapy, glomus jugulare tumors were still evident on magnetic resonance imaging scans, but showed no signs of disease progre ssion. As a result of our experience, we found that a one-stage radical tum or resection performed in collaboration by otologic surgeons and neurosurge ons was the best treatment for patients with large glomus jugulare tumors.