Jugular foramen meningioma – upfront radiosurgery





















SKULL BASE REGION Jugular foramen
HISTOPATHOLOGY N/A
PRIOR SURGICAL RESECTION No
PERTINENT LABORATORY FINDINGS None


Case description


The patient is a 78-year-old male who was incidentally found to have a left jugular foramen mass consistent with meningioma. A 2-year observational period demonstrated persistent growth ( Figure 10.48.1 ), which led to consideration of treatment options. Prior to intervention, the patient had no cranial nerve deficits and had mild symmetric sensorineural hearing loss. In the setting of a growing tumor, normal lower cranial nerve function, older age, and significant cardiac comorbidities, the patient ultimately chose to undergo stereotactic radiosurgery (SRS) ( Figure 10.48.2 ).














Radiosurgery Machine Gamma Knife
Radiosurgery Dose (Gy) 15.5 at the 50% isodose line
Number of Fractions 1



Figure 10.48.1.


A. Initial MRI 2 years prior to stereotactic radiosurgery (SRS): Axial T1-weighted image with gadolinium showing a homogenously enhancing jugular foramen mass with dural tails. B. Subsequent MRI 1 month prior to SRS: Axial T1-weighted image with gadolinium showing increased superior extent involving the proximal internal auditory canal. C. Subsequent MRI 1 month prior to SRS: Coronal T1-weighted image with gadolinium showing superior extention.



Figure 10.48.2.


Imaging of the treatment plan. Yellow line, 16 Gy; green line, 8 Gy; pink line, cochlea outline.



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Apr 6, 2024 | Posted by in GENERAL RADIOLOGY | Comments Off on Jugular foramen meningioma – upfront radiosurgery

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