Primary Middle Ear Meningioma with Intact Tympanic Membrane: A Case Report and Literature Review

Abstract

Primary ectopic meningioma of the middle ear is relatively rare in clinical practice. It is often difficult to distinguish it from chronic otitis media or otitis media with effusion due to its similar and atypical clinical symptoms. We report a case of epithelial tympanic ectopic meningioma with the main complaints of otalgia, aural fullness, and hearing loss. It was accidentally discovered during tympanotomy due to the symptoms of recurring refractory secretory otitis media. This article briefly reviews the relevant literature in recent years, summarizes the characteristics of primary ectopic tympanic meningioma with intact tympanic membrane, and emphasizes the diagnosis and treatment strategy of the middle ear mass.

Symptoms: Fluctuating Vertigo and Aural Fullness

“…However, infection would not be limited to just one quadrant of the TM and acute purulent otitis media is rare in adults. 1 Therefore, it’s crucial to conduct a careful otoscopic exam—which showed the reddish mass behind the TM in this case—and order an MRI to rule out other diagnoses on the differential list. A biopsy will help confirm the diagnosis; however, it should be performed with caution due to the risk of hemorrhage or facial paralysis in the case of an undiagnosed paraganglioma or facial schwannoma, respectively.…”

“…Ectopic meningiomas, which occur outside of the central nervous system such as middle ear meningioma, are rare and account for only 1% of meningiomas. 1 The four subgroups that ectopic meningiomas are classified into include: 1) meningiomas that directly extend from primary intracranial meningiomas, 2) those that grow outside the skull from cranial nerve sheath arachnoid cells, 3) those that extend outside the skull from embryonic arachnoid rests with no connection to the skull base or cranial nerves, and 4) those that result from distant metastasis from intracranial tumors. 2 They are slowly growing tumors that often go undiagnosed for several years (up to or more than 10 years sometimes).…”