A 50-year-old woman presents with pulsatile tinnitus and a retrotympanic vascular mass. High-resolution CT of the temporal bone shows a mass centered on the jugular foramen with irregular, permeative bony margins described as 'moth-eaten'. The most likely diagnosis is:

• A Glomus jugulare ✓
• B Vestibular schwannoma
• C Endolymphatic sac tumor
• D Metastasis

Explanation

Glomus jugulare (paraganglioma) arises from the jugular bulb, classically presenting with pulsatile tinnitus and a retrotympanic mass. CT shows permeative 'moth-eaten' bone destruction centered on the jugular foramen. Vestibular schwannoma widens the internal auditory canal with smooth margins. Endolymphatic sac tumor shows bone destruction centered on the posterior petrous ridge with spiculated calcifications.

Reference: Surgery of the Skull Base, 1st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.