As dealt with in the brain disorder section, the treatment of a glomus jugulare tumour has very much to be tailored to the individual. If they are small and asymptomatic, it is entirely possible that your tumour may be simply observed with follow up scans in the first instance. If you tumour is then shown to be growing, one of 2 treatment options will be possible. The first of these is surgery. If you have intact function of your voice and swallowing nerves, surgery needs to be very careful in order not to jeopardise the function of these nerves.
The alternative treatment for a small but growing tumour would be a specialised form of radiotherapy, namely stereotactic radiosurgery. This is every effective in halting the growth of these tumours, whilst preserving nerve function. It does not remove the tumour but in halting its growth, it can very likely prevent it from causing neurological harm.
If you have a larger tumour which has already resulted in loss of the voice and swallowing nerves, and if it is pressing on your brain, then it is very likely that surgery will be advised. Such surgery is a major undertaking, requiring a whole team to carry it out safely.
The first part of the work-up for surgery will entail having a cerebral angiogram carried out (hyperlink). This will establish the blood supply of the tumour and whether it is possible to safely block off the blood supply. Surgery to a glomus jugulare tumour can really only be safely done after effective embolisation of the tumour (occlusion of the blood supply to the tumour) as they are so rich in blood vessels.
After angiography and embolisation, surgery is usually carried out a few days’ later. This will involve an approach both through the top part of the neck as well as drilling away bone from the base of the skull. In so doing, the tumour can be approached in a safe way with control of the large blood vessels in the vicinity. Whilst such operations are rare, we have considerable experience of doing such surgery with good results.
As part of our routine management for patients presenting with a newly diagnosed glomus jugulare tumour, they will be referred on for an opinion from one of our endocrinology colleagues. The aim of this is two-fold. Firstly it is to establish that the glomus jugulare tumour is not a secretory tumour. On occasion, glomus jugulare tumours can secret adrenalin-like hormones and you will be tested for this. Very rarely, they can also be associated with other sorts of tumours elsewhere in the body, including in the neck or adrenal glands in the abdomen. You will, therefore, undergo routine screening for this.