Management of Previously Radiated Tympanojugular Paraganglioma with Intracranial Invasion and Brainstem Compression

Objective: To discuss the complex management of tympanojugular paraganglioma that exhibit significant intracranial growth despite stereotactic radiotherapy in patients with normal lower cranial nerve function.

Method: Retrospective case report and literature review.

Results: We present a case of an 80-year-old female with a growing left-sided tympanojugular paraganglioma that exhibited significant intracranial invasion and cerebellar compression 3 years after stereotactic radiotherapy. We discuss the differential diagnosis, diagnostic quandaries, and complexities of management of these difficult to treat tumors in the context of a multidisciplinary skull base team involving otolaryngology, neurosurgery, neuroradiology, and radiation oncology team members. We review the literature on the management tympanojugular paraganglioma exhibiting intracranial invasion in the presence of normal lower cranial nerve function.

Conclusion: Management of tympanojugular paraganglioma that exhibit significant growth after stereotactic radiotherapy are challenging tumors to treat and are best treated in the context of a multidisciplinary skull base team.