title: Non-paraganglioma tumors of the jugular foramen - Growth patterns, radiological presentation, differential diagnosis.
abstract: OBJECTIVE
  Most common tumors of the jugular foramen are paragangliomas. However, other lesions, also malignant, may involve the jugular foramen and mimic radiographic presentation of paragangliomas. Therefore, a correct preoperative diagnosis is crucial for best treatment planning. This study analyzes imaging characteristics of non-paraganglioma neoplasms involving the jugular foramen, with attention given to features helpful in differential diagnosis.
  
  
  METHODS
  A retrospective chart search.
  
  
  METHODS
  Teritary referral university centre.
  
  
  METHODS
  During the years 1997-2010, 11 cases of jugular foramen tumors other than paragangliomas, with available imaging studies, were identified. Histopathology revealed: 3 schwannomas, 1 malignant schwannoma, 2 meningiomas, 1 hemangiopericytoma, 1 ependymoma, 1 endolymphatic sac carcinoma (ELST) and 2 nasopharyngeal carcinoma metastases. CT, MRI and angiography were assessed to determine tumor growth directions, bone involvement, tumor morphology and vascular composition.
  
  
  RESULTS
  Schwannomas were characterized by parapharyngeal space involvement, jugular foramen expansion, preservation of cortical margins, irregular contrast enhancement. Meningiomas presented diffuse bone infiltration, sclerotic changes, erosion of the cortical bone. Ependymoma showed diffuse skull base infiltration, permeative erosion, heterogeneity, abundant vascularization. Hemangiopericytoma radiologically imitated paraganglioma. ELST showed permeative/geographic bony destruction, heterogeneity, intratumoral bony fragments. Metastases were lytic, solid lesions characterized by circumferential growth, internal carotid artery encasement and stenosis.
  
  
  CONCLUSIONS
  A combination of certain radiological features including tumor epicenter, growth vectors, skull base infiltration, bony changes and tumor morphology help establish correct preoperative diagnosis and differentiate less common jugular foramen tumors, from most common paragangliomas. Hemangiopericytoma may radiologically mimic paraganglioma.
authors.affiliation: Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland.
authors.forename: A
authors.initials: A
authors.lastname: Szymańska
authors.affiliation: Department of Otolaryngology, Medical University of Lublin, Lublin, Poland. Electronic address: marcinszym@poczta.onet.pl.
authors.forename: M
authors.initials: M
authors.lastname: Szymański
authors.affiliation: Department of Radiology, Medical University of Lublin, Lublin, Poland.
authors.forename: E
authors.initials: E
authors.lastname: Czekajska-Chehab
authors.affiliation: Department of Interventional Radiology and Neuroradiology, Medical University of Lublin, Lublin, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Szczerbo-Trojanowska
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D019292:Skull Base Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D055815:Young Adult
keywords: Angiography; CT; Jugular foramen; MRI; Tumor