Jugulotympanic Paraganglioma: A Rare Cause of Vertigo

Patient: Female, 83 Final Diagnosis: Jugulotympanic paraganglioma Symptoms: Dizziness • tinnitus Medication: — Clinical Procedure: — Specialty: Oncology OBJECTIVE: Rare disease BACKGROUND: Jugulotympanic paraganglioma generally presents in the 5(th) or 6(th) decades of life with tinnitus and hearing loss. In this manuscript, we present a rare case of jugulotympanic paraganglioma presenting in the 9(th) 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.