title: Atypical primary meningioma in the nasal septum with malignant transformation and distant metastasis.
abstract: BACKGROUND
  Primary extracranial meningiomas (PEMs) originating from the nasal septum are extremely rare, as are extracranial metastases of meningiomas.
  
  
  METHODS
  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.
authors: 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. bjbaek@schmc.ac.kr
authors: Byoung Joon
authors: BJ
authors: Baek
authors: Jae-Min
authors: JM
authors: Shin
authors: Chi Kyou
authors: CK
authors: Lee
authors: Ji Hye
authors: JH
authors: Lee
authors: Koen Hyeong
authors: KH
authors: Lee
mesh_terms: D000328:Adult; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D017809:Fatal Outcome; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008579:Meningioma / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D009300:Nasal Septum / Q000473:pathology*; D009362:Neoplasm Metastasis; D009669:Nose Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D012008:Recurrence; D014057:Tomography, X-Ray Computed