Figure 23.

Glomus jugulotympanicum. (A) Coronal CT image demonstrates a soft tissue density lesion in the left jugular fossa with irregular moth-eaten osseous erosion. The mass extends into the middle ear cavity at the cochlear promontory (red arrows), confirming a combined glomus jugulotympanicum. (B) Axial and (C) coronal fat-suppressed T2W images demonstrate heterogeneous hyperintense signal in the lesion (red arrows) with tiny signal voids consistent with hypervascularity. (D) Coronal noncontrast T1W image demonstrates a ‘salt and pepper’ appearance with small foci of hyper- and hypointensity. (E) Coronal postcontrast T1W image shows avid enhancement of the lesion (red arrow). (F) Axial postcontrast CISS image reveals partial encasement of the left ICA (white arrow) and polypoid extension of the lesion into the left CPA cistern (blue arrow) due to dural disruption.