Abstract
Meningiomas are the most common intracranial extra-axial neoplasms with mostly straightforward
radiological diagnosis; however, they can have unusual clinical and imaging manifestations
posing diagnostic dilemma for radiologists and clinicians. The objective of this case
report is to highlight the infrequent and misleading presentations of meningiomas
to make an accurate diagnosis. A 65-year-old male patient presented with complaints
of left recurrent otitis media and facial nerve palsy for past 6 months. On imaging,
an aggressive predominantly cystic intracranial neoplasm was found in the left temporal
fossa extending into the middle and external ear. Histopathological examination of
the excised tumor revealed WHO grade I meningothelial meningioma. Meningiomas can
show atypical imaging features such as large meningeal cysts, heterogenous or ring
enhancement and aggressive features such as bone erosion. They can invade the middle
ear and should be thought of while dealing with nonresponsive cases of otitis media.
Keywords
facial nerve - high-resolution computed tomography - magnetic resonance imaging -
meningioma - otitis media
