Primary jugular foramen meningioma: imaging appearance and differentiating features.
OBJECTIVE
Primary jugular foramen meningiomas behave differently from meningiomas arising elsewhere. The differences have important clinical, imaging, and surgical implications. We reviewed the imaging appearances of primary jugular foramen meningiomas and evaluated them for features that might assist in differentiating them from other common jugular foramen lesions.


METHODS
A retrospective review identified five cases of primary jugular foramen meningioma. We defined it as primary when it was centered in the jugular foramen and secondary when it was centered in the posterior fossa with secondary extension into the jugular foramen. Secondary jugular foramen meningiomas were excluded from this study. Eight cases of jugular foramen paraganglioma and 10 cases of jugular foramen schwannoma were reviewed for comparison.


RESULTS
Primary meningioma was characterized by centrifugal infiltration surrounding the skull base (5/5), a permeative-sclerotic appearance to the bone margins of the jugular foramen (5/5), and prominent dural tails (5/5). Flow voids were absent in all cases. Paraganglioma showed localized skull base infiltration, with predominant superolateral spread into the middle ear cavity (8/8). Flow voids and permeative destruction of the bone margins of the jugular foramen were typical. Schwannoma caused expansion of the jugular foramen with scalloped well-corticate bone margins, without skull base infiltration.


CONCLUSIONS
Primary jugular foramen meningioma is characterized by extensive skull base infiltration. A centrifugal pattern of spread, a permeative-sclerotic appearance of the bone margins of the jugular foramen, the presence of dural tails, and an absence of flow voids are particularly important features that assist in differentiating primary jugular foramen meningioma other more common jugular foramen lesions.
Macdonald
André J
AJ
Department of Diagnostic Radiology, University of Utah, 1A71 Medical Center, 50 N Medical Dr, Salt Lake City, UT 84132, USA.
Salzman
Karen L
KL
Harnsberger
H Ric
HR
Gilbert
Erik
E
Shelton
Clough
C
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008577:Meningeal Neoplasms / Q000175:diagnosis*; D008579:Meningioma / Q000175:diagnosis*; D008875:Middle Aged; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000473:pathology*; D012189:Retrospective Studies; D012888:Skull Neoplasms / Q000175:diagnosis; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed