Jugular foramen meningioma. Report of a case and review of the literature.

The occurrence of a meningioma within the jugular foramen is very rare. We present the case of a 33-year-old man who presented with five-year history of hoarseness and was found to have paralysis of lower four cranial nerves on the left. High resolution computed tomography showed a dumbbell shaped tumor of the left jugular foramen extending intracranially over the jugular tubercle and extracranially into the parapharyngeal space. The patient underwent staged neuro-otological surgery and the mass was removed subtotally with no recurrence in six years. Histopathologic diagnosis was transitional meningioma. Our review of the literature revealed 33 previously reported cases. Four of these cases had neurofibromatosis. All but one underwent some form of otolaryngologic surgery. Although twenty had an intracranial component to their tumor, only 11 had a craniotomy. The majority of the tumors were meningothelial meningiomas (60%). Only two cases were malignant meningiomas. We reviewed the clinical and radiological characteristics and summarized the benefits and pitfalls of existing surgical options.