OTHER-12

Abstract

Abstract Glomus jugulare tumours are rare but present a treatment challenge due to their anatomy, endocrine and cardiovascular effects. Their care requires a multidisciplinary approach. We present the case of a 62year-old female patient who presented with 4-year history of tinnitus, hearing loss and hypertension. Over a period of 2 weeks she decompensated with bulbar dysfunction and rapid cardiovascular instability. MRI demonstrated a 88 cc right jugulotympanicum para-ganglioma with intracranial, extra-axial extension and encasement of cranial nerves VI to XII, and marked mass effect on the brainstem with compression and left displacement of the medulla. The patient also had hydrocephalus. Clinically she had limited physiological reserve. She underwent partial embolization to reduce the hyperdynamic circulation, a total dose of 54Gy in 30 fractions using IMRT technique and ventriculoperitoneal shunt insertion. She had a prolonged critical care stay .However, she progressively improved over a period of six months with the brainstem oedema resolving. Currently, the patient is living independently with normal cardiovascular status. This case demonstrates the benefit of combining endovascular intervention and radiation therapy in the management of glomus tumours.”