Papillary endothelial hyperplasia (Masson tumor) of the petrous and jugulare region: case report and literature review

Abstract: Objective: Intracranial papillary endothelial hyperplasia (PEH) is rare, and only 13 cases have been reported intracranially in the literature. In this article, we present a case of PEH involving petrous and jugular foramen region due to the uncommon incidence. Case Description: A 49-year-old female patient with a 4-year history of left-sided hearing loss and facial palsy. Magnetic resonance (MR) imaging disclosed the presence of a 6 × 6 × 5 cm lobular mass occupying the left petrous and jugulare region. This mass was hyperintense on both T1 and T2 weighted MR images and was enhanced strongly with gadolinium. No edema was found around the lesion. Preoperative digital subtraction angiogram examination showed that the lesion had a rich blood supply. Therefore, polyvinyl alcohol embolization was carried out to reduce bleeding during operation. A left-sided suboccipital extreme lateral approach was applied for craniotomy. The lesion was extradural and highly vascular with extension into the petrous bone. It was subtotally removed. Postoperative course of the patient was stable. Her neurologic evaluation was the same as preoperatively. Conclusion: Surgical excision of the lesion is the main therapy. Radiotherapy should be given to patients whose lesion cannot be totally removed. [Copyright &y& Elsevier]