Bruninx L, Govaere F, Van Dorpe J, Forton G E J
Department of Otolaryngology, Head & Neck Surgery, Heilig Hart General Hospital, Roeselare, Belgium.
B-ENT. 2013;9(2):157-60.
Extracranial meningiomas are common tumours but may occur in unexpected locations. Awareness can avoid misdiagnosis and inappropriate management of these tumours. We report the case of a 54-year-old Caucasian male with en plaque meningioma of the external ear canal and an intracranial temporal lobe meningioma.
The patient underwent extended canal wall down atticomastoidectomy with preservation of the ossicular chain and tympanic membrane and en bloc resection of the bony posterior canal wall, tumour, and overlying skin.
Radical removal of a grade I meningothelial meningioma was achieved. The tegmen tympani and dura were not breached. No connection with the temporal lobe meningioma was demonstrated. The patient recovered completely and experienced a marked improvement in hearing. No clinical signs of recurrent or residual tumour have occurred.
Careful clinical examination and extensive radiological workup is required to avoid missing the unusual diagnosis of concurrent meningioma of the temporal bone and temporal lobe, and miss the chance to treat this disease adequately.
颅外脑膜瘤是常见肿瘤,但可能出现在意想不到的部位。提高认识可避免对这些肿瘤的误诊和不恰当处理。我们报告一例54岁的白种男性患者,患有外耳道斑块状脑膜瘤和颅内颞叶脑膜瘤。
患者接受了扩大的外耳道后壁下乳突切除术,保留听骨链和鼓膜,并整块切除骨性外耳道后壁、肿瘤及覆盖皮肤。
实现了I级脑膜皮型脑膜瘤的根治性切除。鼓室盖和硬脑膜未被侵犯。未发现与颞叶脑膜瘤有联系。患者完全康复,听力有明显改善。未出现复发或残留肿瘤的临床迹象。
需要仔细的临床检查和广泛的影像学检查,以避免漏诊颞骨和颞叶同时发生脑膜瘤这一不寻常的诊断,错失充分治疗该病的机会。