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Case Reports in Medicine
Volume 2013 (2013), Article ID 396805, 3 pages
http://dx.doi.org/10.1155/2013/396805
Case Report

A Rare Case of Large Skull Base Meningioma Mimicking Otitis Media with Effusion

1Division of Otorhinolaryngology, Head & Neck Surgery, Montreal University Hospital Center (CHUM), 1560 Rue Sherbrooke Est, Montréal, QC, Canada H2L 4M1
2Department of Pathology and Cell Biology, University of Montreal, 6128 Succursale Centre-ville, Montréal, QC, Canada H3C 3J7

Received 2 August 2013; Accepted 9 December 2013

Academic Editor: Mark E. Shaffrey

Copyright © 2013 Musaed Alzahrani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 48-year-old woman presented with unilateral hearing loss and tinnitus for three years associated with middle ear effusion. Previous treatments, including antibiotics, corticoids, and transtympanic tube, were ineffective. Otomicroscopy showed a greyish retrotympanic mass associated with middle ear effusion. High resolution CT scan of the mastoid was in favor of chronic oto-mastoiditis without any evidence of tegmen dehiscence. Surgical exploration revealed a polypoid greyish mass filling the tympanic cavity. Histological examination postoperatively revealed a meningothelial meningioma. Postoperative magnetic resonance imaging (MRI) was obtained and showed a large skull base meningioma, extending from the clivus anteriorly to the porus acusticus posteriorly with middle ear invasion. After discussion with the multidisciplinary tumor board, it was managed by stereotactic radiotherapy due to the high surgical associated neurovascular risks. In conclusion, middle ear meningioma, although still a rare presentation, should be suspected in the presence of atypical chronic OME.