Olfactory groove meningioma with paranasal sinus and nasal cavity extension: removal by combined subfrontal and nasal approach.

A very unusual case of olfactory groove meningioma with recurrence extending into the paranasal sinuses and nasal cavities, 15 years after the first transcranial operation, is described. The patient was successfully treated by a combined subfrontal and nasal approach. Large downward extension of an olfactory groove meningioma into the nasal cavities is a rare event, with no or isolated cases reported even in large series of these tumours. The nasal extent of these meningiomas is more often asymptomatic, although signs of sinus obstruction and epistaxis have been described. Although small paranasal sinus extensions of the meningioma may be removed by the transcranial route, a combined subfrontal and nasal approach is necessary in cases with large tumour masses extending into the nasal cavities, as in our own one.