Endovascular superselective embolization in a personalized approach to the diagnosis and treatment of paragangliomas of the lateral base of the skull

Paraganglioma of the lateral base of the skull (PLOC) (glomus tumor of the jugular vein bulb) is a predominantly benign neoplasm developing from paraganglia cells associated with sympathetic and parasympathetic ganglia associated with anatomical formations such as auricular branch of the vagus nerve (Arnold nerve), tympanic nerve (branch of the lingual nerve, Jacobson nerve), jugular bulb veins. Currently, the term paraganglioma of the lateral base of the skull is considered the most adequate. These paragangliomas account for 0.6 % of all neoplasms of the head and, as a rule, are sporadic, however, the probability of genetic predisposition of paragangliomas reaches 30 % in family members of the patient. The incidence of glomus tumor of the lateral base of the skull is 1:300000. Women get sick more often than men — 3:1, and the onset of the disease usually falls on the fifth and sixth decades of life.

THE AIM OF THE STUDY: to improve the results of treatment of patients with hypervascular volumetric formation of PLOC based on the development and introduction into clinical practice of a new method of diagnosis and treatment, namely, endovascular superselective emobolization of tumor tissue.

MATERIALS AND METHODS: to solve this problem, 12 cases of paraganglioma of the lateral base of the skull were studied. These patients underwent endovascular superselective embolization of tumor vessels with non-adhesive compositions and hypospheres.

RESULTS: The authors have introduced into medical practice a personalized method of endovascular superselective vascular emobolization PLOCH. Endovascular superselective embolization was performed in 12 patients with PLOC. Patients with type A and B paragangliomas were embolized with tumor vasculature with microparticles of HepaSphere 200–300 microns. a with type C and D non-adhesive composition and microparticles of HepaSphere 200–300mkm. A direct indicator of the effectiveness of endovascular superselective embolization of paragangliomas of the lateral base of the skull was the progressive death of tumor tissue and, as a consequence, a significant decrease in the size of the tumor itself. After superselective ebolization on day 6–7, patients were discharged and sent to an oncological dispensary at their place of residence. A positive relapse-free effect of treatment was achieved in 8 patients, and in 4 patients, a tumor recurrence was detected after two years. Timely re-hospitalization and newly performed endovascular superselective ebolization turned off the pathological newly grown arterial network of neoplasms from the bloodstream. After superselective ebolization on day 6, these patients were discharged in a satisfactory condition and sent to an oncological dispensary at their place of residence.

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