경정맥공에 발생한 수막종 1례

Abstract

A 56-year-old woman presented right side hearing impairment and tinnitus. The neurological examination revealed accessory nerve weakness at the same side. Computed tomography revealed the widening of jugular foramen (JF). Magnetic resonance imaging disclosed a large homogeneous mass in JF, which appeared as an iso-signal intensity on T2-weighted images and high-signal intensity on enhanced T1-weighted images. It extended into internal auditory canal, the middle ear cavity and cerebellopontine angle(CPA). The patient underwent an infratemporal fossa and suboccipital approach. Intra-operatively, tumor was noted from the middle ear to JF and CPA, and adhesive to low cranial nerves(LCNs). With preserving LCNs, subtotal tumor resection was performed. Histological diagnosis revealed meningothelial meningioma. The patient presented postoperative facial palsy, hoarseness, aspiration, and shoulder weakness, but facial weakness was improved later. At postoperative 6 months, growth of residual tumor in JF was noted and gamma knife surgery was performed. The patient is followed up. We report a case of meningioma in jugular foramen.