The radiology of paragangliomas of the skull base

Salib, Rami, Dutt, Sunil N. and Chavda, S. V. (2001) The radiology of paragangliomas of the skull base. Skull Base, 11 (SUPPL. 2), 23.

Abstract

Paragangliomas are rare tumors of unknown etiology arising from paraganglionic cells in relation to nerves and blood vessels. They are slow growing benign tumors capable of producing paraneoplastic syndromes due to production of hormones. Malignant transformation is extremely rare. The cornerstone of diagnosis of these tumors in the skull base region is imaging. Biopsy is not appropriate as these tumors are extremely vascular and bleed profusely. Four types of paragangliomas are described in the skull base region including glomus tympanicum, glomus jugulare, glomus vagale and carotid body tumors. It is important to differentiate the four types of tumors in order to decide the most appropriate surgical approach for the excision of the tumors. Differences in expansion and invasion may be delineated radiologically and hence morbidity with respect to involvement of the lower cranial nerves may be predicted. It is also possible to decide the best time for surgical intervention in those tumors where a 'wait and watch' policy is exercised. A radiological staging classification is also possible that may help decide the most appropriate modality of management. We describe here, with clinical examples, the characteristic imaging features of the four types of paragangliomas using high resolution Computerized Tomographie scanning (HRCT) and Magnetic Resonance Imaging techniques (MRI).

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Contributors

Author: Rami Salib

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