Ectopic meningioma in the bilateral nasal olfactory cleft: A case report and literature review

Abstract

Certain nasal neoplasms, such as ectopic menigioma, present as nasal polyps, together with similar symptoms. The present study reports the diagnosis and treatment of ectopic meningioma in the bilateral nasal olfactory cleft in order to improve the diagnosis and treatment of ectopic meningioma in the nasal cavity. By retrospectively analyzing the clinical data and reviewing the associated literature, a detailed introduction to the clinical manifestation, diagnosis and treatment of ectopic meningioma of the nasal cavity was ascertained. The tumor was removed from the sinus by functional endoscopy surgery. Regular follow-up appointments were scheduled every three months, with no evidence of recurrence to date. The olfactory recovery and nasal ventilation were normal subsequent to surgery. Meningiomas are infrequently occurring tumors with unpredictable clinical behavior. A clear understanding of the etiology and appropriate diagnostic and management principles may aid in overcoming the challenges of treating primary extracranial meningiomas.

Cytological features of ectopic nasal meningioma. Report of a case diagnosed using FNAC

“…3 Anosmia is generally the first symptom with which patients present, but they can also have a headache or visual problems. 3 They can be clinically or radiologically confused with many benign and malignant neoplasms like epithelial tumours (eg squamous cell carcinomas), vascular tumours like angiofibroma and paraganglioma, melanoma, esthesioneuroblastoma, and mesenchymal tumours like aggressive psammomatous ossifying fibroma. 6 Radiological findings are non-specific and consist of bony sclerosis, opacification of the sinuses, and focal destruction of the surrounding nasal cavity bone.…”

“…Primary extracranial meningiomas, also known as ectopic meningiomas, have no evidence of a direct connection to the brain parenchyma. It is challenging to diagnose such tumours due to their rare site of presentation and often being confused with nasal polyps 3 . Anosmia is generally the first symptom with which patients present, but they can also have a headache or visual problems 3 .…”

“…It is challenging to diagnose such tumours due to their rare site of presentation and often being confused with nasal polyps 3 . Anosmia is generally the first symptom with which patients present, but they can also have a headache or visual problems 3 . They can be clinically or radiologically confused with many benign and malignant neoplasms like epithelial tumours (eg squamous cell carcinomas), vascular tumours like angiofibroma and paraganglioma, melanoma, esthesioneuroblastoma, and mesenchymal tumours like aggressive psammomatous ossifying fibroma 6 .…”

“…Exceptionally it occurs as a primary meningioma in the nasal fossa with an incidence of less than 0.2% 2 . The aetiology of such ectopic meningiomas developing in the nasal cavity is not known 3 . However, it is presumed to arise from the transformation of embryonic arachnoid cell remnants of ectopic melanocytes, which may become entrapped during the closure of midline structures (fusion line inclusion), similar to the development of meningoceles.…”

Primary Extracranial Meningiomas of the Sinonasal Tract: A Systematic Review

“…were positive with varying labelling indexes ranging from 1-20% [13][14][15][16][17][18][19][20][21] , with majority of cases with labelling index of <5%.…”