Presentation
Left side pulsatile tinnitus.
Patient Data
An intensely enhancing well-defined soft tissue mass lesion is seen centered upon the left jugular fossa causing widening and moth-eaten erosions of the jugular foramen. It shows extension into the middle ear cavity hypotymanum abutting the cochlear promontory. The mass is seen eroding the posterior wall of the left carotid canal and slightly abutting the left internal carotid artery. It is seen inseparable from the left jugular vein with no evidence of transverse, sigmoid or jugular vein thrombosis.
Annotated images show the tympanic component of the lesion (white arrows) abutting the cochlear promontory (black arrows).
Case Discussion
The patient's presentation of pulsatile tinnitus and the presence of pulsating vascular mass on otoscopic examination are in keeping with the radiological findings of left jugulotympanic paraganglioma (previously known as glomus jugulotympanicum).
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