Unusual presentation of temporal bone meningioma as chronic otitis media: A case report

Temporal bone meningiomas are uncommon tumors that can present with symptoms mimicking more familiar otologic conditions, such as chronic otitis media. Because these neoplasms are rare and their symptoms nonspecific - especially in adult patients - they are often misdiagnosed, leading to delays in appropriate treatment.

We present the case of a 53-year-old Thai woman who developed persistent left-sided ear pain, itching, aural fullness, and mucopurulent discharge over a 2-month period. Her symptoms progressed despite multiple courses of oral and topical antibiotics. Audiometry revealed unilateral hearing loss, and imaging studies, including high-resolution computed tomography and gadolinium-enhanced magnetic resonance imaging, identified a 2.1 × 1.9 × 1.8 cm extra-axial lesion in the left cerebellopontine angle, extending into the petrous temporal bone. The patient underwent retrosigmoid craniotomy for tumor resection. Gross total excision was achieved, and histopathologic analysis confirmed a World Health Organization Grade I psammomatous meningioma. Her postoperative course was uneventful, and follow-up imaging showed no recurrence.

Temporal bone meningiomas, though rare, should be considered in adults with chronic otologic symptoms that fail to resolve with standard therapy. Neuroimaging is essential in refractory cases to identify underlying skull base pathology. Early diagnosis and timely surgical intervention are critical to prevent neurological complications, including cranial nerve deficits and brainstem compression.