Posterior fossa giant adenoid cystic carcinoma with skull base invasion mimicking glomus jugulare: A case report and review of literature

Abstract

The author describes a rare case of giant adenoid cystic carcinoma (ACC) mimicking large paraganglioma with lower cranial nerve palsy. A 60-year-old female presented with a progressive increase in postauricular swelling with unilateral hearing loss, facial deviation, difficulty in swallowing, and hoarseness of voice. MRI brain showed highly vascular infiltrating and osteolytic mass suggestive of large glomus jugulare versus sarcoma. It was completely engulfing the jugular foramen and lower cranial nerves with bony erosion of the jugular foramen and occipital condyle. The whole mastoid was filled with the tumor. On digital subtraction angiography the majority of blood supply was from the occipital branch of the external carotid artery and vertebral artery. The patient underwent percutaneous embolization followed by external carotid ligation and resection of the mass. The postoperative course was uneventful. Histopathology was suggestive of mixed ACCs. The patient received radiotherapy. After 1 year of follow up no recurrence or distant metastasis was noted.

Basaloid Squamous Cell Carcinoma clinically and radiologically masquerading as a Head & Neck Paraganglioma– A Case Report

“…1,9 This nding is similar to that of other known cases of temporal bone metastases presenting as glomus jugulare tumors as well. 10,11,12,13 However, it is important to note that lower cranial nerve palsies involving the IX th , X th , XI th (and XII th ) cranial nerves (CNs), which are seen in HNPGLs because of mass effects, are also considered common features of metastatic lesions described in the literature as JF syndrome of Vernet (involving IX th , X th , and XI th CNs), posterior laterocondylar syndrome (Vernet's plus XII th CN) and posterior retropharyngeal syndrome (Vernet's plus XII th and Horner's). 12 Furthermore, a 1976 review of temporal bone metastases also described a triad of facial paralysis, otalgia and periauricular swelling to alert a clinician of metastatic temporal bone disease.…”