Case 1
History:
40 year old male with left sided tinnitus
Findings:
There is presence of an enhancing mass with multiple flow voids centered and enlarging the jugular foramen.
Diagnosis:
Glomus Jugulare
Discussion:
Glomus Jugulare comprises approximately 90% of primary tumors involving the jugular foramen. Flow voids are characteristic, with a “salt and pepper” appearance and possible erosion of the jugular spine. Attenuation and signal characteristics are nonspecific isodense CT/strong enhancement CT+MR/hypo T1/hyper T2. The lesions are markedly hypervascular on conventional angiography and preoperative embolization can be performed. Arterial feeders are primarily ECA branches including posterior occipital, ascending pharyngeal, and posterior meningeal. Recurrence is common. Most tumors occur in patients aged 40-70 years, but cases have been reported in patients as young as 6 months and as old as 88 years. Multicentric tumors are found in 3-10% of sporadic cases and in 25-50% of familial cases.
Differential Diagnosis:
Glomus jugulare, metastasis, schwannoma, neurofibroma, meningioma.
