An Extracranial, Infratemporal Meningioma Following Neoadjuvant Radiotherapy: A Case Report

Extracranial meningiomas are uncommon tumors and represent an unusual manifestation of a typically intracranial disease. While most are intracranial, primary extracranial presentations may arise independently or represent extensions of intracranial disease. Radiation exposure is a recognized but uncommon risk factor. We present a case of a 66-year-old male patient who developed a painless, preauricular mass more than a decade after cranial radiotherapy for acromegaly. Imaging revealed a well-circumscribed, enhancing lesion centered in the infratemporal fossa, with bony remodeling but no intracranial extension. Surgical excision was performed using a modified Blair approach, preserving the facial nerve. Histology confirmed a WHO Grade I meningioma. This case highlights the importance of long-term follow-up in irradiated patients and the value of multidisciplinary planning for complex skull base tumors.