open access

Vol 49, No 3 (2015)
Original research articles
Submitted: 2015-01-11
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Non-paraganglioma tumors of the jugular foramen – Growth patterns, radiological presentation, differential diagnosis

A. Szymańska, M. Szymański, E. Czekajska-Chehab, M. Szczerbo-Trojanowska
DOI: 10.1016/j.pjnns.2015.04.003
·
Neurol Neurochir Pol 2015;49(3):156-163.

open access

Vol 49, No 3 (2015)
Original research articles
Submitted: 2015-01-11

Abstract

Objective

Most common tumors of the jugular foramen are paragangliomas. However, other lesions, also malignant, may involve the jugular foramen and mimic radiographic presentation of paragangliomas. Therefore, a correct preoperative diagnosis is crucial for best treatment planning.

This study analyzes imaging characteristics of non-paraganglioma neoplasms involving the jugular foramen, with attention given to features helpful in differential diagnosis.

Study design

A retrospective chart search.

Setting

Teritary referral university centre.

Subjects and methods

During the years 1997–2010, 11 cases of jugular foramen tumors other than paragangliomas, with available imaging studies, were identified. Histopathology revealed: 3 schwannomas, 1 malignant schwannoma, 2 meningiomas, 1 hemangiopericytoma, 1 ependymoma, 1 endolymphatic sac carcinoma (ELST) and 2 nasopharyngeal carcinoma metastases. CT, MRI and angiography were assessed to determine tumor growth directions, bone involvement, tumor morphology and vascular composition.

Results

Schwannomas were characterized by parapharyngeal space involvement, jugular foramen expansion, preservation of cortical margins, irregular contrast enhancement. Meningiomas presented diffuse bone infiltration, sclerotic changes, erosion of the cortical bone. Ependymoma showed diffuse skull base infiltration, permeative erosion, heterogeneity, abundant vascularization. Hemangiopericytoma radiologically imitated paraganglioma. ELST showed permeative/geographic bony destruction, heterogeneity, intratumoral bony fragments. Metastases were lytic, solid lesions characterized by circumferential growth, internal carotid artery encasement and stenosis.

Conclusions

A combination of certain radiological features including tumor epicenter, growth vectors, skull base infiltration, bony changes and tumor morphology help establish correct preoperative diagnosis and differentiate less common jugular foramen tumors, from most common paragangliomas. Hemangiopericytoma may radiologically mimic paraganglioma.

Abstract

Objective

Most common tumors of the jugular foramen are paragangliomas. However, other lesions, also malignant, may involve the jugular foramen and mimic radiographic presentation of paragangliomas. Therefore, a correct preoperative diagnosis is crucial for best treatment planning.

This study analyzes imaging characteristics of non-paraganglioma neoplasms involving the jugular foramen, with attention given to features helpful in differential diagnosis.

Study design

A retrospective chart search.

Setting

Teritary referral university centre.

Subjects and methods

During the years 1997–2010, 11 cases of jugular foramen tumors other than paragangliomas, with available imaging studies, were identified. Histopathology revealed: 3 schwannomas, 1 malignant schwannoma, 2 meningiomas, 1 hemangiopericytoma, 1 ependymoma, 1 endolymphatic sac carcinoma (ELST) and 2 nasopharyngeal carcinoma metastases. CT, MRI and angiography were assessed to determine tumor growth directions, bone involvement, tumor morphology and vascular composition.

Results

Schwannomas were characterized by parapharyngeal space involvement, jugular foramen expansion, preservation of cortical margins, irregular contrast enhancement. Meningiomas presented diffuse bone infiltration, sclerotic changes, erosion of the cortical bone. Ependymoma showed diffuse skull base infiltration, permeative erosion, heterogeneity, abundant vascularization. Hemangiopericytoma radiologically imitated paraganglioma. ELST showed permeative/geographic bony destruction, heterogeneity, intratumoral bony fragments. Metastases were lytic, solid lesions characterized by circumferential growth, internal carotid artery encasement and stenosis.

Conclusions

A combination of certain radiological features including tumor epicenter, growth vectors, skull base infiltration, bony changes and tumor morphology help establish correct preoperative diagnosis and differentiate less common jugular foramen tumors, from most common paragangliomas. Hemangiopericytoma may radiologically mimic paraganglioma.

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Keywords

Angiography, CT, Jugular foramen, MRI, Tumor

About this article
Title

Non-paraganglioma tumors of the jugular foramen – Growth patterns, radiological presentation, differential diagnosis

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 49, No 3 (2015)

Pages

156-163

DOI

10.1016/j.pjnns.2015.04.003

Bibliographic record

Neurol Neurochir Pol 2015;49(3):156-163.

Keywords

Angiography
CT
Jugular foramen
MRI
Tumor

Authors

A. Szymańska
M. Szymański
E. Czekajska-Chehab
M. Szczerbo-Trojanowska

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