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Asad Jehangir, Ranjan Pathak, Bilal Shaikh, Ahmed Salman, Shoaib Bilal Fareedy, Anam Qureshi, Qasim Jehangir, Richard Alweis
(Department of Internal Medicine, Reading Health System, West Reading, PA, USA)
Am J Case Rep 2015; 16:228-231
Jugulotympanic paraganglioma generally presents in the 5th or 6th decades of life with tinnitus and hearing loss. In this manuscript, we present a rare case of jugulotympanic paraganglioma presenting in the 9th decade with vertigo as the most bothersome symptom.
Case Report: An 83-year-old woman presented with worsening episodes of dizziness of a few months duration. She also complained of tinnitus and hearing loss, more severe on the left side. Examination revealed a red bulging left-sided tympanic membrane, conductive hearing loss, and a bruit at the base of the skull. Dix-Hallpike test was negative. CT head and MRI brain revealed findings consistent with a large left-sided jugulotympanic paraganglioma, which was found to be hormonally inactive on laboratory tests. The patient underwent treatment with radiotherapy, which resulted in partial improvement of symptoms.
Conclusions: Jugulotympanic paraganglioma may manifest in the elderly with the chief complaint of intermittent vertigo, as in our case. A red bulging mass on otoscopy raises the suspicion, necessitating further investigations, including CT and MRI.
Keywords: Diagnosis, Differential, Aged, 80 and over, Glomus Jugulare Tumor - diagnosis, Magnetic Resonance Imaging, Tomography, X-Ray Computed, Vertigo - etiology