410 Post-Radiotherapy Infratemporal Extracranial Meningioma: A Case Report

This case report details the complex management of a 66-year-old male, Mr. CF, with a history of acromegaly treated by post-transsphenoidal hypophysectomy and radiotherapy. He presented with a gradually enlarging left preauricular lump, identified as a meningioma through imaging studies. Despite initial observation due to the absence of symptoms, the tumour exhibited rapid growth, prompting surgical intervention. The surgery was technical, due to surgical field and various critical structures, yet successfully managed to preserce the facial nerve. Histological analysis confirmed a Grade I WHO meningioma. Subsequent follow-ups revealed residual extra-cranial meningioma tissue, prompting continued watchful waiting due to the low risk of malignant transformation for Grade I meningiomas. Follow-up imaging demonstrated growth in residual foci, highlighting the challenges of managing recurrent meningiomas. The report underscores the importance of a multidisciplinary approach and vigilant monitoring in meningioma cases, especially when involving intricate anatomical regions. Despite postoperative complications, the patient remains asymptomatic, and the risk of malignancy remains low. Continued surveillance is planned, emphasizing the need for long-term follow-up strategies in the management of recurrent meningiomas. This case contributes valuable insights into the complexities of surgical decision-making and the ongoing challenges in treating meningiomas.