Jugular Paraganglioma Presenting With Collet-Sicard Syndrome

Abstract

A 60-year-old woman presented with a 4-year history of right-sided pulsatile tinnitus and progressive hearing loss. She reported 2 years of worsening nasal reflux, dysphonia, dysphagia, right shoulder weakness, dysarthria, and difficulty moving her tongue. Physical examination was significant for a red pulsatile middle ear mass. Examination also revealed palatal asymmetry, right vocal cord paralysis, right shoulder depression with trapezius atrophy, and tongue deviation to the right, findings consistent with right-sided paralysis of cranial nerves IX through XII, respectively (Figure and Supplemental Video, available online at http://www.mayoclinicproceedings.org). Imaging revealed a large erosive lesion centered on the jugular foramen with extension into the middle ear. A jugular paraganglioma with lower cranial nerve involvement was diagnosed. In this case, the tumor resulted in Collet-Sicard syndrome, a rare jugular foramen syndrome describing paralysis of cranial nerves IX, X, XI, and XII. eyJraWQiOiI4ZjUxYWNhY2IzYjhiNjNlNzFlYmIzYWFmYTU5NmZmYyIsImFsZyI6IlJTMjU2In0.eyJzdWIiOiI5YjdkNjcyODViOThlOTBmYjU5YzcxNTUwNDgxY2Y2ZCIsImtpZCI6IjhmNTFhY2FjYjNiOGI2M2U3MWViYjNhYWZhNTk2ZmZjIiwiZXhwIjoxNjc5MDIzMzQ3fQ.pC24mhoGY7fKBt_inedCGMLbKI49YeXR0YRBJUFFEgFPdG-3dpokPq8SAuGnPuNlQmjHssHa1JEWhPc2B-WmcogEq1UY5L2y8Hr0ea6U2dwtX-iOUTuZ-sHtSRSohkNi9tMBNr9cBid__VP0uefGvzYh-3sCjMJQG9EcYDj5kl23zqE0_-MbDBmDMrI1AdSOqCi_Eu7GM6ltL07QQKEUFzzJf6CNH4u6Tzoa5dG0hfEmvQz0gcjvDkCo-b49NFUYb04-fTptqGASLqQV-Zs9Gw4iAqXqtuTpIDjXCyA-fhRpydzP2jQ8B6sVy8DuEA9VvGIWcskZtEy7PnwHYu5hGg Download .mp4 (50.93 MB) Help with .mp4 files Supplemental Video Supplemental material can be found online at: http://www.mayoclinicproceedings.org. Supplemental material attached to journal articles has not been edited, and the authors take responsibility for the accuracy of all data.