When Jugular Foramen Schwannoma Imitates Other Skull Base Tumors Insights from Advanced Imaging

Abstract

Jugular schwannoma is a rare benign neoplasm arising from the sheath of the lower cranial nerves within the jugular foramen. Its deep anatomical position and overlapping imaging characteristics with other skull base lesions often complicate diagnosis. We report the case of a 30-year-old male presenting with tinnitus, vertigo, and gait disturbance, in whom imaging findings were crucial for diagnosis. Contrast-enhanced computed tomography (CT) demonstrated a heterogeneously enhancing, partially solid lesion occupying the jugular foramen with evidence of adjacent bone erosion. Magnetic resonance imaging (MRI) revealed a mass that appeared hypointense on T1-weighted images, hyperintense on T2-weighted sequences, and showed moderate to marked post-contrast enhancement. Histopathological evaluation confirmed the diagnosis of jugular schwannoma. This case emphasizes the pivotal role of multimodal imaging—particularly high-resolution MRI, CT with bone detail, and MR angiography—in distinguishing jugular schwannoma from other skull base tumors such as paraganglioma, meningioma, or metastasis by assessing bone remodeling, vascularity, and the nerve of origin. Early and accurate radiologic identification of jugular schwannoma is essential for appropriate surgical planning and improved patient outcomes.