title: Jugulotympanic paraganglioma: a rare cause of vertigo.
abstract: BACKGROUND
  Jugulotympanic paraganglioma generally presents in the 5th or 6th decades of life with tinnitus and hearing loss. In this manuscript, we present a rare case of jugulotympanic paraganglioma presenting in the 9th decade with vertigo as the most bothersome symptom.
  
  
  METHODS
  An 83-year-old woman presented with worsening episodes of dizziness of a few months duration. She also complained of tinnitus and hearing loss, more severe on the left side. Examination revealed a red bulging left-sided tympanic membrane, conductive hearing loss, and a bruit at the base of the skull. Dix-Hallpike test was negative. CT head and MRI brain revealed findings consistent with a large left-sided jugulotympanic paraganglioma, which was found to be hormonally inactive on laboratory tests. The patient underwent treatment with radiotherapy, which resulted in partial improvement of symptoms.
  
  
  CONCLUSIONS
  Jugulotympanic paraganglioma may manifest in the elderly with the chief complaint of intermittent vertigo, as in our case. A red bulging mass on otoscopy raises the suspicion, necessitating further investigations, including CT and MRI.
authors.affiliation: Department of Internal Medicine, Reading Health System, West Reading, PA, USA.
authors.forename: Asad
authors.initials: A
authors.lastname: Jehangir
authors.affiliation: Department of Internal Medicine, Reading Health System, West Reading, PA, USA.
authors.forename: Ranjan
authors.initials: R
authors.lastname: Pathak
authors.affiliation: Department of Internal Medicine, Reading Health System, West Reading, PA, USA.
authors.forename: Bilal
authors.initials: B
authors.lastname: Shaikh
authors.affiliation: Department of Internal Medicine, Reading Health System, West Reading, PA, USA.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Salman
authors.affiliation: Department of Internal Medicine, Reading Health System, West Reading, PA, USA.
authors.forename: Shoaib Bilal
authors.initials: SB
authors.lastname: Fareedy
authors.affiliation: Department of Internal Medicine, King Edward Medical University, Lahore, Pakistan.
authors.forename: Anam
authors.initials: A
authors.lastname: Qureshi
authors.affiliation: Department of Internal Medicine, Rawalpindi Medical College, Rawalpindi, Pakistan.
authors.forename: Qasim
authors.initials: Q
authors.lastname: Jehangir
authors.affiliation: Department of Internal Medicine, Reading Health System, West Reading, PA, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Alweis
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D005925:Glomus Jugulare Tumor / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging; D014057:Tomography, X-Ray Computed; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology*