Chen Zeng-Chang, Wang Cheng-Ping, Hsiao Jong-Kai, Ko Jenq-Yuh, Tseng Ham-Min, Yao Yu-Tung
Department of Otolaryngology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Head Neck. 2007 Aug;29(8):793-8. doi: 10.1002/hed.20571.
Meningiomas involving the jugular foramen and parapharyngeal space are extremely rare. They most commonly occur intracranially and then extend to the extracranial region through the foramen of the skull base, such as jugular foramen. Clinically, these tumors mimic the more common glomus jugulare tumor. Preoperative diagnosis can be correct on the basis of the characteristic imaging findings.
A 52-year-old woman was seen with a left neck mass and mixed-type hearing loss. She underwent physical examination, MRI, high-resolution CT, and angiography.
Physical examination revealed a retro-tympanic, pulsatile red mass in the left ear, and mild bulging of the left oropharyngeal wall. The patient was found to have the spreading, carpet-like, meningioma with extracranial extensions via jugular foramen to parapharyngeal space. Preoperative imaging strategy allowing accurate preoperative diagnosis is discussed.
Accurate distinction between meningioma and glomus tumor or schwannoma is possible in most cases, with attention to fine radiologic detail.
累及颈静脉孔和咽旁间隙的脑膜瘤极为罕见。它们最常起源于颅内，然后通过颅底孔道，如颈静脉孔，延伸至颅外区域。临床上，这些肿瘤类似更常见的颈静脉球瘤。基于特征性影像学表现，术前诊断可以正确做出。
一名52岁女性因左侧颈部肿块和混合型听力丧失前来就诊。她接受了体格检查、磁共振成像（MRI）、高分辨率计算机断层扫描（CT）和血管造影检查。
体格检查发现左耳鼓膜后有一个搏动性红色肿块，左侧口咽壁轻度隆起。该患者被发现患有呈地毯样蔓延且经颈静脉孔向咽旁间隙颅外延伸的脑膜瘤。讨论了能实现准确术前诊断的术前影像学策略。
在大多数情况下，注意细微的影像学细节，脑膜瘤与神经鞘瘤或神经瘤之间的准确鉴别是可能的。
