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A Paraneoplastic Syndrome Associated with Glomus Tumors of the Skull Base? Early Observations

Independent secretion of vasoactive substances by glomus tumors of the skull base Is widely recognized. Surgical removal of these tumors often results in an unexplained prolonged postoperative Ileus, even in cases in which the vagus nerve Is preserved. There Is evidence that these tumors may secrete neuropeptides, such as cholecystokinin, in addition to catecholamines. A retrospective analysis of cases of glomus tumors of the skull base operated on at the Otology Group was carried out to correlate preoperative neuropeptide levels, vagus nerve status at surgery, and duration of postoperative Ileus. High circulating levels of cholecystokinin associated with these tumors may be responsible for the unexplained phenomenon of prolonged postoperative ileus. The relevance of neuropeptides to the postoperative management of these patients is discussed. Preventative measures that may avert the potentially lethal complications of aspiration and negative nitrogen balance are described.