Head and Neck Imaging

Meningioma, extracranial

For a general description, see meningioma. Extracranial meningiomas are rare. The most frequent sites for extracranial meningiomas are the orbit, nose (Fig.1), paranasal sinuses and middle ear, and at the skull base foramina. Extracranial meningiomas are formed by direct extension outside the skull of a primary intracranial meningioma, by metastasis from a malignant intracranial meningioma, or originate from extracranial arachnoid cell clusters. These cell clusters accompany certain of the cranial nerves outside the cranium.

The imaging characteristics are similar to those of intracranial meningioma: an enhancing mass lesion, remodelling bone, is seen; the neighbouring bone may appear very sclerotic, possibly mimicking fibrous dysplasia head and neck (Fig.2).

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Fig.2

Patient with clinical diagnosis of left middle ear cholesteatoma. However, the bone alterations visible on the axial CT image (arrows, a) led to the suspicion of a meningioma. Coronal T1-weighted spin-echo images show a large temporal fossa meningioma, growing through the skull base into the infratemporal fossa (arrow, b), and also extending into the middle ear (arrow, c).
Meningioma, extracranial, Fig.1
Meningioma, extracranial, Fig.2 (a)
Meningioma, extracranial, Fig.2 (b)
Meningioma, extracranial, Fig.2 (c)