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J Neurol Surg Rep. 2014 Aug;75(1):e170-4. doi: 10.1055/s-0034-1378154. Epub 2014 Jun 24.

Perioperative management of catecholamine-secreting glomus jugulare tumors.

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1
Department of Neurosurgery and Stroke Center, Tokyo Metropolitan Police Hospital, Tokyo, Japan.
2
Department of Anesthesiology, Tokyo Metropolitan Police Hospital, Tokyo, Japan.

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:

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

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