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Jugulotympanic Paraganglioma: A Rare Cause of Vertigo

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

DOI: 10.12659/AJCR.893366

Background: 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.

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