Extracranial Sinonasal Meningioma Section Presenting as Progressive Nasal Obstruction in a Seven-year-old Male: A Case Report

Meningiomas originating outside the cranium, located on the sinonasal tract, are rare, especially in children, and frequently present with non specific, vague clinical symptoms similar to those observed in more common nasal pathologies. Hereby, the authors report the case of a seven-year-old male with a one-year history of progressive bilateral nasal obstruction without epistaxis, nasal drainage, or headaches. Nasal endoscopy showed a firm, pinkish, polypoid, round mass within the right nasal cavity, and the septum was deviated to the left. Contrast-enhanced Computed Tomography (CECT) revealed a well-defined, non enhancing mass in the right nasal cavity. The mass forced the right globe laterally but did not invade the orbit or intracranial cavity. The patient underwent an endoscopic endonasal approach to completely excise the mass. During the procedure, the mass was friable and vascular, yielding 10 to 15 mL of serosanguineous fluid, and was adherent to the sphenoid and medial maxillary walls. The medial portion of the eye orbit was intact, and bleeding stopped during surgery. The biopsy indicated that the patient had an extracranial meningioma. Following surgery, the patient experienced no complications and has shown no signs of postoperative issues. The present case highlights the importance of considering an extracranial meningioma in the differential diagnosis of a paediatric nasal mass with ossified or cystic features.