Dijagnostika i liječenje glomus tumora temporalne kosti

master's thesis

• Title (english): Diagnosis and treatment of temporal bone glomus tumors
• Author: Marijana Šupe
• Mentor: Srećko Branica (mentor)
• Committee member: Mario Bilić (predsjednik povjerenstva)
• Committee member: Mirko Ivkić (član povjerenstva)
• Committee member: Srećko Branica (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Othorhinolaryngology and Head and Neck Surgery); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Otorhinolaryngology

Abstract

Glomus tumori (poznati još kao paragangliomi ili kemodektomi) su rijetki tumori
nastali iz autonomnog živčanog sustava. U najvećem broju slučajeva ovi tumori su benigni te
su specifični po visokoj vaskulariziranosti i sporom rastu. Iako su najčešći tumori u području
srednjeg uha, incidencija im je niska. Javljaju se s učestalošću oko 1 na 300000. Češće se
javljaju kod žena. Iako su izrazito niskog malignog potencijala, opisane su metastaze na
različitim lokalizacijama. Glomus tumori se pojavljuju pojedinačno ili u sklopu autosomnodominantih
naslijeđenih sindroma. Najčešći simptomi su nagluhost, pulsatilni šum i bol.
Širenjem tumora u okolne strukture mogu se javiti i drugi simptomi kao što su vrtoglavice,
pareze kranijalnih živaca, glavobolje, krvarenje iz uha. Otoskopski u bubnjištu najčešće
uočavamo crvenu, vaskularnu tvorbu koja se uzdiže iz hipotimpanona, poznatu kao znak
izlazećeg sunca. Kirurška resekcija za sada je jedini mogući način liječenja, iako je resekcija
posebno velikih tumora najčešće praćena velikim i teškim lezijama kranijalnih živaca (VIXII)
i velikih krvnih žila koje značajno utječu na pacijentovu kvalitetu života. Uz adekvatnu
preoperativnu pripremu više od 80-90% slučajeva tumora će biti uspješno uklonjeno u
cijelosti. Dodatni načini liječenja uključuju radioterapiju i stereotaksijsku radiokirurgiju koju
koristimo kao palijativnu metodu ili primarni način liječenja osobito velikih inoperabilnih
tvorbi.

Abstract (english)

Glomus tumors (also known as paragangliomas or chemodectomas) are rare
tumors originating from the autonomic nervous system. They are benign in the majority of
cases and are characterized by a strong vascularisation and slow growth. Even though they are
most common tumors in the middle ear, their incidence is low. They occur with a frequency
of about 1 in 300000. They occure more common in women. The malignant potential is very
low, but widely spread metastases can be found. Glomus tumors can develop spontaneously
or as a part of an autosomal-dominant inherited syndrome. The most common symptoms are
hearing loss, pulsatile tinnitus and pain. With the expansion of the tumor into surrounding
structures other symptoms such as vertigo, paralysis of cranial nerves, headaches and ear
bleeding may occur. The most common otoscopic finding is a red, vascular formation that
arises from the hypotympanum, known as the rising sun sign.
Complete surgical resection represents the only treatment option even though resection of
locally advanced tumors regularly results in lesions of the lower cranial nerves (VI-XII) and
major vessels that have a significant impact on patients quality of life. With adequate
preoperative preparation in 80-90% of the cases the tumor will be entirely successfully
removed. Additional treatments include radiotherapy and stereotactic radiosurgery that can be
used as a palliative method or primary treatment method, especially in large inoperabile
lesions.

• Keywords: glomus tumori; paragangliomski sindromi; kirurško liječenje; radioterapija; radiokirurgija
• Keywords (english): glomus tumors; paraganglioma syndromes; surgery; radiotherapy; radiosurgery
• Language: croatian
• URN:NBN: urn:nbn:hr:105:994102
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-09-25 12:35:50