Jugular Foramen Lesions

Case A: A heterogeneously enhancing mass centered within the left jugular foramen is noted. Close inspection demonstrates a “salt and pepper” imaging appearance resulting from internal flow voids most visible along the superior aspect of the lesion on the coronal postcontrast image. The axial T1 postcontrast image demonstrates a superolateral pattern of growth with extension to the hypotympanum and middle ear cavity. Attention to the CT images reveals an expanded left jugular foramen with irregular bony margins laterally and an erosive/permeative pattern of bony destruction. The postcontrast CT image inferior to the skull base clearly demonstrates invasion and expansion of the left jugular vein.

Case B: A predominantly homogeneously enhancing, smoothly contoured mass centered within the left jugular foramen is seen. Of note, cystic degeneration is evident with a large intratumoral cyst along the superior aspect of the lesion, which is best evident on the coronal postcontrast image. A superomedial pattern of growth is noted, with mass effect on the medulla. On CT images, smooth cortical expansion of the jugular foramen is noted. Postcontrast CT images demonstrate the lesion compressing, but not invading, the adjacent jugular bulb.

Case C: An avidly enhancing mass without internal flow voids is noted within a right dominant jugular foramen. Dural en-plaque growth and the presence of dural tails are clearly evident on the axial T1 postcontrast image. Infiltration/invasion of bone is noted in most directions with involvement of the temporal bone, clivus, mastoidectomy cavity, and C1 vertebral body (as seen on coronal postcontrast image). The axial CT image demonstrates a permeative-sclerotic pattern of bone involvement.

Case D: An aggressive-appearing, enhancing mass is noted surrounding the right jugular foramen in a patient with a known history of lung cancer, as noted in the history and as evident on the chest CT scan. Multiple enhancing metastatic lesions are noted involving the right cerebellum and vermis (axial T1 postcontrast image), as well as the superior left insula and corona radiata (coronal T1 postcontrast image). Axial CT images demonstrate an aggressive, lytic pattern of bone destruction.