Tympanic paraganglioma

Case contributed by Mostafa Elfeky
Diagnosis almost certain

Presentation

Pulsatile tinnnitis. Retrotympanic reddish mass.

Patient Data

Age: 50 years
Gender: Female
ct
This study is a stack
Axial
non-contrast
This study is a stack
Axial
non-contrast
This study is a stack
Axial
non-contrast
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Info

A retrotympanic small soft tissue density lesion is noted at the right middle ear cavity, lateral to the promontry, oval window and facial recess. Intact jugular plate and floor of tympanic cavity.

mri
This study is a stack
Axial
T1
This study is a stack
Axial
T1
This study is a stack
Axial
T1 C+
This study is a stack
Axial Heavy
T2 (CISS)
This study is a stack
Coronal
T2
This study is a stack
Coronal
T1
This study is a stack
Coronal
T1 C+
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Info

Right middle ear cavity shows a 6 mm lobular opacity is noted at the region of promontory, round window and facial recess, showing diffuse post-gadolinium enhancement. Intact jugular plate and floor of tympanic cavity.

Case Discussion

Right tympanic paraganglioma (Glasscock/Jackson - type 1) 1. Tympanic paragangliomas are the most common tumor of the middle ear cavity. They arise from the Jacobson nerve at the cochlear promontory. It appears as a soft tissue mass lateral to the cochlear promontory with intact jugular bulb. Contrast-enhanced MRI shows avid enhancement.

Case courtesy Prof. Dr Mohamed Eid, Professor of Radiodiagnosis, Alexandria University, Egypt.

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