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DOI: 10.1055/s-0036-1592633
The Feasibility of a Wait and Scan Period as Initial Management Strategy for Glomus Jugulotympanicum Tumors of Fisch Class C and D
Objective: To evaluate the feasibility of a wait and scan period as initial management strategy for glomus jugulotympanicum tumors of Fisch class C and D.
Design: Retrospective cohort study.
Methods: Medical files of all glomus jugulotympanicum tumors were evaluated retrospectively. We documented demographic information, genetic mutations, presenting symptoms, tumor size and growth, tumor-induced complications and consecutive surgical/radiotherapeutic intervention.
Results: We evaluated 5 C1, 10 C2, 5 C3 and 3 De1 class tumors in 21 patients (15 women, age 16 - 79, mean 41.6). Six tumors were SDHD related, 2 SDHA and 5 were SDHB related. The initial presentations were hearing loss/vertigo (n = 10), dysphonia (n = 2) and sensation of pressure (n = 2). The rest of the tumors were found by screening of family members. Tumor size at presentation ranged between 4 and 130 mm (mean 35.5mm). The motivation for the initial wait and scan period was refusal of treatment in 2 patients. For the remaining patients, it was initiated since risk of treatment was considered too high when compared with patients’ symptoms. During the wait and scan period (mean 7.3; range 0.5–19 years), one tumor was found to induce N. XI pareses. For 10 of 23 patients consecutive treatment was necessary due to tumor growth (for radiotherapy n = 3, for surgery n = 7).
Conclusion: An initial wait and scan period seems a feasible management strategy for Fisch class C and D tumors. Tumor induced morbidity seems to be minimal and half of patients seem to require consecutive treatment due to tumor growth.