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[A case of jugular foramen meningioma in a child]
Abstract:
The common tumors originating in the jugular foramen are chemodectoma and schwannoma. Jugular foramen meningioma is extremely rare. Review of the literature revealed only seven reported cases of this tumor. The authors present a child case of jugular foramen meningioma with intra and extracranial extension. A 9-year-old boy was admitted to the Department of Neurosurgery, Hiroshima University School of Medicine on March 20, 1985. Since the age of 3, the patient had hoarseness and was found to tilt his neck when he shouted. Since the age of 6, he was found to nod when he swallowed. At the age of 8, he developed swallowing difficulties. On admission, his general condition was unremarkable except for his lean build (126 cm in height and 23 kg in weight). An elastic hard and immobile mass was palpable in the left upper neck deep in the atrophic sternocleidomastoid muscle. Neurological examination revealed involvement of the ninth, tenth, eleventh, and twelfth cranial nerves. A plain skull roentgenogram and laminogram revealed hyperostosis around the left jugular foramen, and narrowing of the canal. CT with contrast enhancement revealed a high density mass in the left cerebellopontine angle extending through the jugular foramen to the left parapharyngeal space. Cerebral angiography did not show any abnormal findings except for complete blockage of the left sigmoid sinus. On April 4, 1985, subtotal removal of the intracranial tumor was performed using suboccipital craniotomy. Then, on July 3, 1985, the left parapharyngeal tumor was excised through a cervicofacial incision. Finally the residual tumor in the jugular foramen was excised using suboccipital approach on August 18, 1986.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
This study presents a rare case of jugular foramen meningioma in a child, detailing its intra and extracranial extension. Surgical intervention was performed in stages to remove the tumor and address associated cranial nerve deficits.
Area of Science:
- Neurosurgery
- Oncology
- Pediatric Neurology
Background:
- Jugular foramen meningiomas are exceptionally rare, with only seven cases documented in medical literature.
- Chemodectoma and schwannoma are more common tumors found at the jugular foramen.
Observation:
- A 9-year-old boy presented with a 6-year history of hoarseness, neck tilting, and progressive swallowing difficulties.
- Physical examination revealed a palpable neck mass and neurological deficits involving cranial nerves IX, X, XI, and XII.
- Imaging studies, including CT and angiography, demonstrated a large tumor with intra and extracranial extension, involving the jugular foramen and sigmoid sinus.
Findings:
- The patient underwent a multi-stage surgical resection of the jugular foramen meningioma, including intracranial and extracranial components.
- Histopathological analysis confirmed the diagnosis of meningioma.
- The surgical approach involved suboccipital craniotomy and cervicofacial incision.
Implications:
- This case highlights the importance of considering rare diagnoses like jugular foramen meningioma in pediatric patients with complex neurological symptoms.
- Successful surgical management, though challenging, can lead to improved outcomes for these rare tumors.
- Further research into the etiology and optimal treatment strategies for pediatric jugular foramen meningiomas is warranted.