A RARE TYPE OF EXTRACRANIAL MENINGIOMA-CASE REPORT

Abstract

Objective -Meningiomas arising from
paranasal sinuses are rare,less than 40
cases have been reported in the literature.
This objective is to report a patient
with a rare type of meningioma arising
from the ethmoidal sinus presenting with
proptosis and nasal obstruction and highlight
the treatment modality. Method- A
twenty five year-old male patient with the
complaints of nasal obstruction and proptosis
and dimness of vision on the right
eye with the diagnosis of primary extracranial
meningioma of the paranasal sinuses
. MRI showed a irregular, illdefined,
heterogenously enhancing lesion
involving right side maxillary,right anterior
posterior ethmoidal and frontal sinuses.
Result -Total surgical resection by
a facial translocation approach was done
and patient recovered with no morbidity.
Conclusion - Extra cranial meningioma
accounts only 2 of all meningioma
.The most common localizations
of extracranial meningiomas are the skull
bone,scalp, nose, orbit, paranasalsinuses,
middle ear,neck and skin.The most frequent
chromosomal aberration are
monosomy 22,and Von Recklinghausen
neurofibromatosis (NF-I). Friedman et al
on reviewing the literature,found fewer
than 150 cases of extracranial meningiomas
of the head neck reported.Only 31 of
these involved the paranasal sinuses
.Clinical presentation is usually with
n a s a l o b s t r u c t i o n , h e a d -
ache ,epistaxis ,hyposmiaanosmia, nose
deformity, proptosis, orbital pain,blurring
of vision,diplopia.The diagnosis of these
tumors is dificult,. It is part of the differential
diagnosis of squamous cell carcinoma,
angiofibroma (specially in men), esthesioneuroblastoma,
sarcoma and lymphomas
Recent advances in skull base surgery
enable radical resection of these tumors.
Long term follow up is necessary to
monitor for recurrences.