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45 year old female with ataxia.

Glomus jugulare

Schwannoma

Meningioma

Chondroid and chordoma lesion

Metastasis

Enlarged jugular bulb (normal variant)

Jugular bulb pseudolesion

Nasopharyngeal carcinoma.

Most frequent metastatic lesions to skull base from prostate, lung and breast

Breast and lung -- lytic

Prostate -- osteoblastic, may mimic meningioma

Destructive bone changes at jugular foramen margins on CT

Inhomogenous enhancement on MR.

Benign tumor arising from glomus bodies (neural crest cells) in and around the jugular foramen

Most common tumor at Jugular foramen

40-60 y/o; M:F = 1:3

Clinical

Objective pulsatile tinnitus

Retrotympanic vascular mass

Cranial neuropathy (9-11)

Mimics malignancy.

CT findings

Poorly marginated mass with permeative/ destructive changes

Large at presentation (2-6 cm)

Superolateral spread through floor of middle ear cavity

MR findings

“salt & pepper” appearance

Heterogenous on T1 and T2 with numerous hypointense foci (“pepper”) from internal arterial flow voids

Intense enhancement

MR defines soft tissue extent of tumor

May extend intraluminal within IJ or sigmoid sinus.

Angiographic findings

Hypervascular mass

ECA supply

Enlarged feeding arteries with rapid, intense tumor blush

Early venous drainage.