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Jugular / Jugulotympanic Paraganglioma - Radiology

last modified on: Thu, 12/14/2023 - 13:22

  • Also known as: glomus jugulare paraganglioma, glomus jugulotympanicum paraganglioma, jugular foramen paraganglioma; jugulotympanic paraganglioma is preferred (Young et al.)
  • Benign tumor of neural crest origin (Ishak et al. 2020)
  • Can arise from three distinct locations: the jugular bulb, the tympanic branch of CN IX, or the auricular branch of CN X
  • Slow-growing lesion, most often benign (Young et al.)
  • Physical exam may show a bluish pulsating mass behind the tympanic membrane (Young et al.)
  • Occurs most commonly between ages 40-60 with a 1:3 male to female predominance (Moore et al. 2016)
  • Symptoms may include pulsatile tinnitus, hearing loss, dysphonia, shoulder weakness/pain, dysarthria, facial paralysis (Moore et al. 2016)
  • Look for bony erosion on CT and "salt and pepper" appearance on T1 and T2 MR (Moore et al. 2016)
  • On CT: look for permeative-destuctive bone changes, especially jugular spine erosion on non-contrast; intense enhancement with contrast
  • On MR: "salt" appearance on T1 (white dots), "pepper" appearance on T2 (black dots), hyperintense and good spread definition on post-contrast T1

References

Moore MG, Netterville JL, Mendenhall WM, Isaacson B, Nussenbaum B. Head and Neck Paragangliomas: An Update on Evaluation and Management. Otolaryngol Head Neck Surg. 2016 Apr;154(4):597-605. doi: 10.1177/0194599815627667. Epub 2016 Feb 9. PMID: 26861230.

Ishak C, Danda V. Jugular foramen paragangliomas: preoperative transcatheter particle embolization. J Cerebrovasc Endovasc Neurosurg. 2020 Dec;22(4):273-281. doi: 10.7461/jcen.2020.E2019.09.033. Epub 2020 Dec 18. PMID: 33334087; PMCID: PMC7820265.

Young WF. Paragangliomas: Epidemiology, clinical presentation, diagnosis, and histology. In: UpToDate, Post TW (Ed), Wolters Kluwer. (Accessed on December 14, 2023.)