Primary temporal bone secretory meningioma presenting as chronic otitis media

Abstract

We report an extremely rare case of a secretory meningioma primarily involving the temporal bone. A 56-year old female patient presented to us with a history of a chronic otitis media and unilateral hearing loss. Diagnostic investigations revealed a tumor arising from the temporal bone without signs of intracranial involvement. Histopathological examination showed a meningioma of the secretory type. The tumor was partially resected and serial imaging at follow-up revealed no extension of the tumor. No new symptoms developed 1 year after surgery. Secretory meningioma is a rare meningioma subtype and extracranial presentation in the temporal bone is very unusual. We present the first case of a primary temporal bone secretory meningioma in the otorhinolaryngological literature. As radical as possible surgical excision with serial imaging at follow-up is recommended.

Fig. 1

High resolution Computed Tomography (CT) in the axial plane (a) with coronal reconstruction (b) of the petrous bones shows in the right ear middle ear and mastoid cells a soft tissue mass (asterisks). The ossicular chain was intact and not displaced. There was no evidence of destruction of the petrous bone or mastoid

Fig. 2

Secretory meningeoma with many round pseudo-psammoma bodies (HE, original magnification ×200)

Fig. 3

a Post-contrast T1–WI MRI of the head. In the middle cranial fossa on the right side, a homogeneous hyper-intense mass on the axial plane can be seen (asterisk), in close contact to the temporal bone. Also thickening and hyper-intense signal intensity of the tentorium (arrows) represent the “dural tail”. b, c On the coronal and sagittal images the extension of the mass into the petrous bone with spread to the epitympanon can be seen (small arrows)