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J Neurol Surg Rep 2014; 75(01): e170-e174
DOI: 10.1055/s-0034-1378154
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Perioperative Management of Catecholamine-Secreting Glomus Jugulare Tumors

Yu Teranishi
1   Department of Neurosurgery and Stroke Center, Tokyo Metropolitan Police Hospital, Tokyo, Japan
,
Michihiro Kohno
1   Department of Neurosurgery and Stroke Center, Tokyo Metropolitan Police Hospital, Tokyo, Japan
,
Shigeo Sora
1   Department of Neurosurgery and Stroke Center, Tokyo Metropolitan Police Hospital, Tokyo, Japan
,
Hiroaki Sato
1   Department of Neurosurgery and Stroke Center, Tokyo Metropolitan Police Hospital, Tokyo, Japan
,
Naoko Haruyama
2   Department of Anesthesiology, Tokyo Metropolitan Police Hospital, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

21 August 2014

13 April 2014

Publication Date:
24 June 2014 (online)

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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.

Keywords

glomus jugular tumor - pheochromocytoma - catecholamine - surgical strategy - skull base surgery
 

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