A Case of Intracranial Meningioma Involving The External Auditory Canal Directly Through The Temporal Bone : Case Description

This case report describes a rare instance of a 46-year-old female presenting with left ear stuffiness, hearing loss, and purulent discharge. Initially misdiagnosed with mastoiditis, imaging and biopsy ultimately revealed a meningioma. The case's uniqueness lies in the tumor's pathway: it originated in the cerebellopontine angle and extended directly through the temporal bone to involve the external auditory canal, a route seldom documented in scientific literature.The diagnostic challenge was significant due to the atypical symptoms, which mimic common conditions like cholesteatoma. Computed tomography (CT) demonstrated bone erosion, suggesting the direct pathway, while enhanced magnetic resonance imaging (MRI) was crucial for illustrating the continuity between the intracranial mass and the external auditory canal lesion, including a characteristic dural tail sign.This case adds substantial value to the literature by highlighting an unusual mechanism of tumor spread. It underscores the importance for clinicians and radiologists to include meningioma in the differential diagnosis of aural masses, particularly when imaging shows a connection to intracranial structures, to guide appropriate surgical management and avoid diagnostic delays.