Published in:
Open Access
01-07-2018 | Review
Current Treatment of Endolymphatic Sac Tumor of the Temporal Bone
Authors:
William M. Mendenhall, Carlos Suárez, Alena Skálová, Primož Strojan, Asterios Triantafyllou, Kenneth O. Devaney, Michelle D. Williams, Alessandra Rinaldo, Alfio Ferlito
Published in:
Advances in Therapy
|
Issue 7/2018
Login to get access
Abstract
An endolymphatic sac tumor (ELST) is a rare, indolent but locally aggressive tumor arising in the posterior petrous ridge. Patients present with sensorineural hearing loss and tinnitus. As the tumor progresses, patients may experience vertigo, ataxia, facial nerve paresis, pain and otorrhea. Most patients present in their 4th or 5th decade with a wide age range. Patients with von Hippel–Lindau disease have an increased likelihood of developing ELST. Histologically, ELST is a low-grade adenocarcinoma. As it progresses, it destroys bone and extends into adjacent tissues. The likelihood of regional or distant metastases is remote. The optimal treatment is resection with negative margins. Patients with positive margins, gross residual disease, or unresectable tumor are treated with radiotherapy or radiosurgery. Late recurrences are common, so long follow-up is necessary to assess efficacy. The likelihood of cure depends on tumor extent and is probably in the range of 50–75%.