Intraosseous meningioma mimicking chronic otitis media

Intraosseous meningiomas (IOMs) are a rare entity, comprising approximately 1% of intracranial meningiomas, and are characterized by en plaque extension.

A 58-year-old woman had a right-sided hearing disturbance for 8 years. She visited the Department of Otolaryngology and was diagnosed with conductive hearing loss and an intact tympanic membrane. Neuroimaging revealed extensive hyperostotic changes in the right temporal bone and an extradural mass protruding from the middle fossa floor, in addition to an enhanced right middle ear cavity. She initially underwent tympanoplasty with the presumptive diagnosis of chronic otitis media. The right middle ear cavity was occupied by a soft tumor. Histopathological diagnosis was meningothelial meningioma. Microbiological examination did not identify any causative organisms. Three weeks later, she underwent a biopsy of the middle fossa lesion. Intraoperatively, an abnormally thickened middle fossa floor was partially resected with the extradural tumor. Histopathological appearance was consistent with meningothelial meningiomas.

IOMs occurring in the temporal bone may be confused with chronic otitis media. It should be considered as a differential diagnosis in patients with extensively hyperostotic changes in the temporal bones.