A primary extracranial meningioma presenting as a painless nasal root mass

Extracranial meningioma remains a rare entity with few cases reported in literature. This report illustrates a unique case of a 28-year-old woman presenting with a deformity at the root of the nose which was investigated and treated as a primary extracranial meningioma. We discuss the presentation of this rare lesion and the challenges in its diagnosis and management. Literature has been reviewed to provide guidance for clinicians in diagnostic methods. A 28-year-old caucasian woman presented to the ear, nose and throat (ENT) clinic with a painless swelling at the root of the nose. Fine needle aspirations identified cells of an uncertain nature therefore an open biopsy was undertaken. This revealed features in keeping with a benign meningioma. Contrast MRI scan revealed an enhancing lesion involving the crista galli and cranial aspect of the nasal bone. No parenchymal involvement was found and the tumour was categorised as a primary extracranial meningioma. Multidisciplinary involvement from maxillofacial, neurosurgeons and ENT surgeons was required to arrange suitable surgical excision due to local extension of the tumour. The patient was warned of serious side effects including the risk of complete anosmia.