Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Connecticut, USA.
Head Neck. 2010 Dec;32(12):1720-7. doi: 10.1002/hed.21242.
Functional glomus jugulare tumors (GJTs) are commonly managed with resection. Although primary radiation therapy of functional GJT can provide durable control of tumor growth, little is known of its ability to ablate functional capacity.
We describe a case of a 47-year-old man with a symptomatic norepinephrine-hypersecreting GJT treated with definitive single-fraction gamma knife radiosurgery and pharmacologic catecholamine blockade. At a 32-month follow-up, he has experienced significant symptomatic improvement, excellent control of local tumor growth, minimal treatment-related morbidity, and near normalization of catecholamine levels.
Radiosurgery was safe and effective in significantly reducing the functional capacity of a paraganglioma. Care must be taken to avoid inducing a hypertensive crisis during and following treatment, and longer follow-up will help determine whether and when pharmacologic blockade can be discontinued.
功能性颈静脉球体瘤（GJT）通常通过手术切除进行治疗。虽然功能性 GJT 的原发性放射治疗可以提供肿瘤生长的持久控制，但对于其消除功能性的能力知之甚少。
我们描述了一例 47 岁男性患者，其患有有症状的去甲肾上腺素分泌过多的 GJT，接受了确定性单次分割伽玛刀放射外科手术和儿茶酚胺阻断药物治疗。在 32 个月的随访中，他经历了显著的症状改善，局部肿瘤生长得到了极好的控制，治疗相关的发病率很小，儿茶酚胺水平接近正常化。
放射外科手术在显著降低副神经节瘤的功能性方面是安全且有效的。在治疗期间和之后必须小心避免引发高血压危象，更长时间的随访将有助于确定是否以及何时可以停止药物阻断。
