Extradural temporal meningioma directly extended to cervical bone--case report.

A 42-year-old male presented with a rare extracranial meningioma manifesting as right facial swelling, facial nerve paresis, and hearing disturbance. Neurological imaging revealed a primarily extra-axial tumor extending from the temporal base to the subcutaneous space in the parietal region, and partially into the intra-axial region of the temporal lobe through the dura mater, with a small intracerebral hematoma and a small mass in the porus acusticus destroying the temporal bone, the floor of the middle fossa, zygomatic arch, and porus acusticus. Malignant meningioma was confirmed by histological examination after subtotal tumor removal via the transzygomatic approach. Subdural fluid accumulation like hematoma occurred 5 days after surgery and malignant cells were found in the fluid drained by skull trephination. Subsequently, radiation therapy with a total dose of 60 Gy was administered. One year later, he complained of head and neck pain with motor and sensory disturbances in the right upper extremity, and then developed tetraparesis. Cervical x-ray films demonstrated a compression fracture of the C3 vertebral bone and radiolucent areas at C2-4 levels, while computed tomography showed the tumor invading the subcutaneous space and compressing the spinal cord. He died of respiratory distress. Autopsy revealed that the tumor originated in the temporal region and had directly extended to the cervical region.