Nasal Glial Heterotopia: Unsuspected Brain Tissue in the Nasopharynx

Abstract

Objective: To report a case of ectopic brain tissue in the nasopharynx; discuss the differential diagnoses for and management of, this unilateral nasal mass in a pediatric patient, and describe the diagnostic difficulties and eventual treatment. Methods: Study Design:      Case Report Setting:                 Tertiary Government Hospital Participant:                      One   Results:  A 13-year-old boy consulted with an obstructing mass in the nasopharynx and severe muscle wasting, weight below his age and concurrent anemia.  CT-scan revealed a soft-tissue mass occupying a maxillary sinus and nasopharynx consistent with an antrochoanal polyp.  Initial biopsy revealed a papilloma, but the clinical picture warranted preoperative preparations for a possible vascular tumor such as juvenile angiofibroma.  Transpalatal excision and final histopathology yielded nasal glial heterotopia.  Conclusion: When confronted with a unilateral nasal mass in a pediatric patient, aside from the usual considerations, embryologic anomalies particularly those of the intracranial protrusion variety should be strongly considered. Scrupulous preoperative evaluation and sufficient diagnostic modalities must be pursued in order to arrive a correct diagnosis, treatment plan and prevent possible complications especially those related to intracranial communication. Keywords: Nasal glioma, glial heterotopia, congenital nasal masses