Jugular foramen schwannoma

Jugular foramen schwannomas are a rare type of intracranial schwannoma that presents as a jugular fossa mass involving the jugular foramen.

In those without neurofibromatosis type 2 (NF2), they tend to present between the 3rd to 6th decades of life. There is a recognised female predilection 1. The tumours can have a wide variety of clinical presentations.

They can arise from cranial nerves IX, X or XI, with IX being the most common 3.

  • usually well demarcated
  • tend to be iso to hypoattenuating to brain parenchyma 3
  • may show expansion and remodelling of the affected jugular foramen
  • may have a characteristic dumbbell configuration

Signal characteristics are those of a schwannoma:

  • T1: typically low signal
  • T2: typically high signal
    • cystic degeneration may be seen in larger tumours
  • T1 C+ (Gd)
    • smaller lesions demonstrate intense homogeneous enhancement
    • larger lesions tend to have heterogeneous enhancement

As with most schwannomas, they tend to be slow growing tumours. Surgical resection is often the treatment of choice.

For a full list of differentials see the article on jugular fossa masses. Considerations in this location include:

  • paraganglioma: glomus jugulare tumour
    • “salt and pepper” appearance on MR images with intense contrast enhancement and multiple small flow voids
      • vascular schwannomas may have peripheral flow voids but should not have internal flow voids
    • if large, irregular erosion of the margin of the jugular foramen, with decalcification or destruction of the surrounding bone
    • possible invasion of jugular bulb/vein with intraluminal growth (compared to compression by schwannomas)
  • meningioma around the jugular foramen 2
  • metastatic malignant tumours or lymphoma
    • may be indistinguishable from schwannoma when involving jugular foramen
    • most likely destruction of surrounding bone, with less sharply marked borders
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Article information

rID: 10721
Section: Pathology
Synonyms or Alternate Spellings:
  • Jugular schwannoma
  • Jugular foramen schwannoma (JFS)
  • Jugular neurilemmoma
  • Jugular foramen neurilemmoma

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