Diagnostic challenges of sinonasal extracranial meningiomas: A case report

Background and aim: Meningiomas, the most prevalent non-glial intracranial neoplasms, exhibit different biological features and are typically identified with a characteristic dural tail sign on MRI. However, a subset, approximately 7-16% can manifest extracranially. This case report presents a 70-year-old-woman with nasal dysp-nea and intermittent epistaxis due to an ectopic meningioma originating from the nasal cavity, a rare extracranial location. Additionally, a thorough review of the relevant literature was conducted. Methods: Radiological imaging, including maxillofacial CT and MRI, revealed a solid tissue occupying the left nasal cavity, having its origin in middle turbinate. The patient underwent endoscopic sinus surgery (ESS), leading to the histological diagnosis of a WHO grade I meningothelial meningioma with psammomatous bodies. Follow-up at 3-6-12 months showed no recurrence. Results: Extracranial meningiomas constituting less than 1% of non-epithelial tumors, often mimic other sinonasal masses, posing diagnostic challenges. Comprehensive radiological investigation, complete surgical removal, and thorough histopathological examination are crucial for accurate diagnosis and effective treatment planning. Conclusions: This report and literature review emphasizes the importance of preoperative diagnostic-instrumental paths and highlight specific radiological patterns for differential diagnosis, contributing to the understanding and the management of this rare presentation of meningiomas. (www.actabiomedica.it).