Serous otitis media revealing temporal en plaque meningioma.
OBJECTIVE
To present a series of temporal en plaque meningiomas involving the middle ear or mastoid, whose main symptoms suggested a serous otitis media.


METHODS
Multicentric retrospective study reviewing clinical records originating from eight tertiary referral centers.


METHODS
The clinical records of 10 patients presenting with signs and symptoms suggesting serous otitis media and whose neuroimaging studies revealed a temporal en plaque meningioma involving the middle ear or mastoid are reported.


RESULTS
All the patients were women, ranging from 49 to 71 years old. The delay between the onset of symptoms and the diagnosis of meningioma varied from 1 to 10 years. All the patients underwent various procedures usually applied for the treatment of serous otitis media, which failed in all the cases, particularly ventilating tube placement, which was followed by severe episodes of discharge. In all cases, the computed tomographic scans showed three imaging signs: soft tissue mass filling the middle ear or mastoid, hyperostosis of the petrous bone, and hairy aspect of the intracranial margins of the affected bone. This imaging triad must alert the otologist of the possibility of intracranial meningioma. Magnetic resonance imaging was the method of choice to assess the diagnosis of intracranial meningioma involving the middle ear or mastoid. When analyzing management options, it appeared that conventional middle ear procedures were inefficient.


CONCLUSIONS
Temporal en plaque meningioma involving the middle ear or mastoid can mimic a serous otitis media. A computed tomographic scan is recommended for cases of atypical or prolonged unilateral serous otitis media to investigate indirect signs of a meningioma, which has to be confirmed with magnetic resonance imaging.
Ayache
Denis
D
Otology-Neurotology Unit, Fondation A. de Rothschild, Paris, France. dayache@fo-rothschild.fr
Trabalzini
Franco
F
Bordure
Philippe
P
Gratacap
Benoit
B
Darrouzet
Vincent
V
Schmerber
Sébastien
S
Lavieille
Jean-Pierre
JP
Williams
Marc
M
Lescanne
Emmanuel
E
D000368:Aged; D003937:Diagnosis, Differential; D004432:Ear, Middle / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008416:Mastoid / Q000473:pathology*; D008577:Meningeal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008579:Meningioma / Q000175:diagnosis* / Q000473:pathology; D008875:Middle Aged; D010034:Otitis Media with Effusion / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed