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Open Access Case report

Atypical primary meningioma in the nasal septum with malignant transformation and distant metastasis

Byoung Joon Baek1*, Jae–Min Shin1, Chi Kyou Lee1, Ji Hye Lee2 and Koen Hyeong Lee3

Author Affiliations

1 Department of Otolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan Hospital, 23-20 Bongmyung-Dong, Cheonan, 330-721, Chungcheongnam-do, South Korea

2 Department of Pathology, Soonchunhyang University College of Medicine, Cheonan, South Korea

3 Sangdang Otorhinolaryngologic clinic, Cheongju, South Korea

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BMC Cancer 2012, 12:275  doi:10.1186/1471-2407-12-275

Published: 3 July 2012

Abstract

Background

Primary extracranial meningiomas (PEMs) originating from the nasal septum are extremely rare, as are extracranial metastases of meningiomas.

Case presentation

A 44-year-old male presented with a 2-month history of left-side nasal obstruction and frequent episodes of epistaxis. A friable mass originating from the nasal septum was resected completely via an endoscopic endonasal approach. According to WHO criteria, the tumor was diagnosed as an atypical meningioma radiologically and histopathologically. Two years later, a tumor recurred at the primary site with the same histopathological findings, and the patient was given local external radiotherapy (6840 cGy in 38 fractions). Two months after this local recurrence, a left anterior chest wall mass and a left parietal area scalp mass were observed. The subcutaneous mass was resected and showed histological evidence of malignant transformation. Several months after the last operation, the patient died.

Conclusions

We describe the clinical, radiological, and bio-pathological features of this unique case and review the literature on atypical PEMs originating in the nasal septum. To our knowledge, this is the first reported case of an atypical PEM originating from the nasal septum that recurred with malignant transformation and extracranial metastasis.

Keywords:
Extracranial meningiomas; Ectopic meningiomas; Atypical meningiomas; Nasal septum; Nasal cavity; Metastasis