Jugular Foramen’s Paraganglioma in a Patient with Von Hippel-Lindau Disease: Case Report
Arq. bras. neurocir; 40 (2), 2021
Publication year: 2021
Glomus jugular tumors, also known as paragangliomas (PGLs), are rare and related to
several clinical syndromes described. These are located in the carotid body, the jugular
glomus, the tympanic glomus and the vagal glomus. The symptoms are directly related to
the site of involvement and infiltration. These lesions have slow growth, are generally
benign and hypervascularized, have a peak incidence between the age of 30 to 50 years old;
however, when associated with hereditary syndromes, they tend to occur a decade earlier.
Several familial hereditary syndromes are associated with PGLs, including Von Hippel-
Lindau disease (VHL) in< 10% of the cases. The diagnosis and staging of PGLs are based on
imaging and functional exams (bone window computed tomography [CT] with a “ground
moth” pattern and magnetic resonance imaging (MRI) with a “salt and pepper” pattern).
The cerebral angiography is a prerequisite in patients with extremely vascularized lesions,
whose preoperative embolization is necessary. The histopathological finding of cell clusters
called “Zellballen” is a characteristic of PGLs. Regarding the jugular foramen, the
combination of two or three surgical approaches may be necessary: (1) lateral group,
approaches through themastoid; (2) posterior group, through the retrosigmoid access and
its variants; and (3) anterior group, centered on the tympanic and petrous bone. In the
present paper, we report a case of PGL of the jugular foramen operated on a young female
patientwho underwent a surgery with a diagnosis ofVonHippel-Lindau Disease (VHL) at the
Neurosurgery Service of the Hospital Heliópolis, São Paulo, state of São Paulo, Brazil in
2018, by the lateral and posterior combined route.
Paraganglioma/diagnóstico por imagen, Paraganglioma/cirugía, Foramina Yugular/anomalías, Foramina Yugular/cirugía, Neoplasias de la Base del Cráneo/cirugía, Enfermedad de von Hippel-Lindau/complicaciones, Pérdida Auditiva Sensorineural/etiología, Embolización Terapéutica/métodos, Angiografía Cerebral/métodos