case_images: PMC11027019_01
case_images: Shows a right side 5 by 5 cm large jugular foramen mass predominantly iso intense on T1 & hyper intense on T2 with extensive multiple & large size intra & peritumoral flow voids as it appears hypointense on both T1 & T2 MRI (see dark arrows of Figure 1). The dark arrow on postcontrast axial MRI in figure shows the "drop out" phenomenon. The tumor also had "salt-and-pepper" pattern (the orange & blue arrow shows the salt & pepper respectively as seen in Figure 1).
case_images: fsurg-11-1353400-g001.jpg
case_images: PMC11027019_01_fsurg-11-1353400-g001.jpg
case_images: F1
case_images: T2, respectively, with extensive, multiple, and large intra- and peritumoral flow voids, as it appeared hypointense on both T1 and T2 MRIs (see dark and dark red arrows in Figures 1, 2, respectively). The tumor also had a "salt-and-pepper" pattern (the orange and blue arrows show the salt and pepper, respectively, as seen in Figure 1) due to multiple areas of flow void from high vascularity and hyperintense foci produced by slow flow or subacute hemorrhage, respectively, on both T1 and T2 images. The tumor had avid post-contrast enhancement (see Figure 3), and the multiple intra- and peritumoral flow voids still appear hypo-intense even on a post-contrast MRI, suggesting a phenomenon called "drop out" (as seen by the dark arrows in Figure 1, including on the post-contrast image), which is commonly found in glomus jugulare tumors.
case_images: Shows with extensive multiple & large size intra & peritumoral flow voids (depicted by the dark red) as it appears hypointense on T2 MRI in axial, coronal and sagittal section. The blue arrow also shows acute hydrocephalus.
case_images: fsurg-11-1353400-g002.jpg
case_images: PMC11027019_01_fsurg-11-1353400-g002.jpg
case_images: F2
case_images: T2, respectively, with extensive, multiple, and large intra- and peritumoral flow voids, as it appeared hypointense on both T1 and T2 MRIs (see dark and dark red arrows in Figures 1, 2, respectively). The tumor also had a "salt-and-pepper" pattern (the orange and blue arrows show the salt and pepper, respectively, as seen in Figure 1) due to multiple areas of flow void from high vascularity and hyperintense foci produced by slow flow or subacute hemorrhage, respectively, on both T1 and T2 images. The tumor had avid post-contrast enhancement (see Figure 3), and the multiple intra- and peritumoral flow voids still appear hypo-intense even on a post-contrast MRI, suggesting a phenomenon called "drop out" (as seen by the dark arrows in Figure 1, including on the post-contrast image), which is commonly found in glomus jugulare tumors. Acute obstructive hydrocephalus, as evidenced by tri-ventriclar enlargement and cerebrospinal fluid (CSF) transependymal transudation, was also noted, as seen by the blue arrow in Figure 2.
case_images: Shows the avid post contrast enhancement in different planes of sections. It also shows the extension of tumor to middle ear, mastoid air cells and part of petrous bone.
case_images: fsurg-11-1353400-g003.jpg
case_images: PMC11027019_01_fsurg-11-1353400-g003.jpg
case_images: F3
case_images: T2, respectively, with extensive, multiple, and large intra- and peritumoral flow voids, as it appeared hypointense on both T1 and T2 MRIs (see dark and dark red arrows in Figures 1, 2, respectively). The tumor also had a "salt-and-pepper" pattern (the orange and blue arrows show the salt and pepper, respectively, as seen in Figure 1) due to multiple areas of flow void from high vascularity and hyperintense foci produced by slow flow or subacute hemorrhage, respectively, on both T1 and T2 images. The tumor had avid post-contrast enhancement (see Figure 3), and the multiple intra- and peritumoral flow voids still appear hypo-intense even on a post-contrast MRI, suggesting a phenomenon called "drop out" (as seen by the dark arrows in Figure 1, including on the post-contrast image), which is commonly found in glomus jugulare tumors.
case_images: Bone window of CT scan showing an extremely widened right side jugular foramen (depicted by the orange arrow of Figure 4) with a characteristic "moth-eaten" pattern (depicted by blue arrow of Figure 4) of destruction of petrous part of temporal bone.
case_images: fsurg-11-1353400-g004.jpg
case_images: PMC11027019_01_fsurg-11-1353400-g004.jpg
case_images: F4