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October 1987

Persistence of Norepinephrine Secretion After Radiotherapeutic Management

Arch Otolaryngol Head Neck Surg. 1987;113(10):1046. doi:10.1001/archotol.1987.01860100024011

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At the American Neurotologic Society meeting in Denver, Mitchell Schwaber, MD, assistant professor in the Department of Otolaryngology at Vanderbilt University, Nashville, Tenn, reported persistence of norepinephrine secretion from a glomus jugulare tumor following radiotherapeutic management. A 58-year-old woman with hypertension and tremulousness had undergone multiple prior subtotal glomus jugulare surgical procedures. With a long history of hypertension, she had suffered two cerebrovascular accidents and was not considered to be a good surgical candidate. Prior to radiotherapy, peripheral blood and internal jugular vein norepinephrine levels were measured. Following radiotherapy, the norepinephrine levels remained elevated, and her hypertension still needed to be controlled with phenoxybenzamine. At 20 months following radiotherapy, the tumor size had not changed as noted by computed cranial tomography, but hypertension persisted. Dr Schwaber concluded that radiotherapy did not substantially affect the chief cells that made up the endocrine-active portion of the tumor, but that it probably included

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