Glomus jugulare tumors masquerading as benign intracranial hypertension

Intracranial hypertension has been reported as a complication of massive glomus jugulare tumors with intracranial extension. We describe a patient with papilledema, failing vision, and a diagnosis of benign intracranial hypertension with bilateral glomus jugulare tumors that went undetected for 2 years. There was no evidence of intracranial invasion by the tumors to explain the elevation of intracranial pressure. Embolization followed by surgical removal of the left tumor resulted in stabilization of the neurologic condition and preservation of the lower cranial nerves, including intact hearing. The likely mechanism of intracranial hypertension in this case is an impairment of cerebrospinal fluid absorption. This unusual presentation should be recognized to avoid delayed diagnosis and treatment. Furthermore, intracranial hypertension is not always associated with massive intracranial tumor involvement, as had been previously proposed.