MRI, CT scan, and octreotide scan of a vagal paraganglioma

The images demonstrate a left sided vagal paraganglioma that extends from the posterior fossa through the jugular foramen into the neck. The T1-weighted post-gadolinium MRI scans (images A, B, and C) show an intensely enhancing mass in the posterior fossa (arrow, A), extending through the jugular foramen (arrow, B), and into the neck (arrow, C) where the dark flow voids reflect blood vessels within the tumor. Image D is a sagittal reconstruction of a contrast-enhanced CT scan showing the extent of the tumor and the intimate relationship with the great vessels (arrows). Erosion of the bone in the region of the jugular foramen is shown (arrow, E) on the bone windows. The affinity of the paraganglioma for octreotide is shown by radionuclide imaging with 111-indium pentetreotide (image F).