Department of Surgery, Division of Neurosurgery, Duke University Medical Center, 220 Sands Building, Research Drive, Box 3050, Durham, NC 27710, USA.
J Neurooncol. 2010 Jul;98(3):427-30. doi: 10.1007/s11060-009-0091-2. Epub 2009 Dec 19.
Temporal paragangliomas are highly vascular tumors treated primarily by surgical resection. However, surgery to remove these tumors is associated with significant morbidity, including cranial nerve dysfunction. Interestingly, these tumors have been shown to express vascular endothelial growth factor (VEGF). A variety of tumors expressing VEGF and the VEGF receptor have been shown to reduce in size and vascularity when treated with the VEGF-specific antibody, bevacizumab (Avastin). We hypothesized that paragangliomas may be treated noninvasively with bevacizumab, either as a primary treatment or as a useful adjuvant to surgical resection or radiation. Thus, our aim was to evaluate the effects of bevacizumab on this patient's paraganglioma. A 36-year-old female presented to us with a 3 month history of positional dizziness, light-headedness, and left ear pulsatile tinnitus and hearing loss. She was found to have a temporal paraganglioma (glomus jugulare tumor) on imaging. Histopathology confirmed significant staining for VEGF. This patient was treated with bevacizumab prior to surgical treatment; radiographic imaging at 3 months, however, showed no significant response. We discuss possible reasons for treatment failure.
时间性副神经节瘤是高度血管性肿瘤，主要通过手术切除治疗。然而，手术切除这些肿瘤与显著的发病率相关，包括颅神经功能障碍。有趣的是，这些肿瘤已被证明表达血管内皮生长因子（VEGF）。已经表明，多种表达 VEGF 和 VEGF 受体的肿瘤在用 VEGF 特异性抗体贝伐单抗（阿瓦斯汀）治疗后，其大小和血管密度会降低。我们假设副神经节瘤可以通过贝伐单抗进行非侵入性治疗，无论是作为主要治疗方法还是作为手术切除或放疗的有用辅助手段。因此，我们的目的是评估贝伐单抗对该患者副神经节瘤的治疗效果。一名 36 岁女性因 3 个月的位置性头晕、头晕、左耳搏动性耳鸣和听力损失就诊。影像学检查发现颞部副神经节瘤（颈静脉球体瘤）。组织病理学证实 VEGF 染色明显。该患者在手术治疗前接受了贝伐单抗治疗；然而，3 个月时的影像学检查显示没有明显的反应。我们讨论了治疗失败的可能原因。
