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Magnesium in the management of catecholamine-secreting glomus tumours with intracranial extension

[Le magnésium dans le traitement des tumeurs glomiques sécrétantes à catécholamine avec extension intracrânienne]

From the Department of Neuroanaesthesia, Institute of Neurological Sciences, Southern General Hospital, Glasgow, United Kingdom.

Address correspondence to: Dr. Colin M. Goutcher, Department of Neuroanaesthesia, Institute of Neurological Sciences, Southern General Hospital, 1345 Govan Road, Glasgow, G51 4TF, United Kingdom. Phone: +44 (0) 141 201 1989; Fax: +44 (0) 141 201 2299; E-mail: c.goutcher{at}ntlworld.com

Purpose: Catecholamine-secreting glomus jugulare tumours are uncommon and their anesthetic management can be challenging. The authors present the first description of the use of magnesium sulfate in the management of two patients with catecholamine-secreting glomus jugulare tumours where there was significant intracranial extension.

Clinical features: Patient 1 underwent a transmastoid transoccipital excision of a catecholamine-secreting glomus tumour. He exhibited marked hemodynamic instability after handling of the tumour began, which was not controlled by sodium nitroprusside. Improved hemodynamic stability was seen after the patient received magnesium sulfate. Patient 2 also underwent a transmastoid transoccipital excision of a catecholamine-secreting glomus tumour. Magnesium sulfate was commenced prior to tumour handling and continued until the tumour was removed. The patient remained hemodynamically stable. Sodium nitroprusside was not required.

Conclusion: Magnesium sulfate may be useful in preventing or minimizing the blood pressure changes associated with handling during excision of catecholamine-secreting glomus jugulare tumours. It may be of particular benefit in patients where there is significant intracranial extension.