Respiratory difficulty caused by an ectopic brain tissue mass in the neck of a two-month-old baby: a case report (original) (raw)
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MMJ-A Journal by MIMER Medical College, Pune, India
Nasal glial heterotopia (NGH) is a benign congenital malformation wherein abnormally located mature brain (glial) tissue presents as a mass on the forehead or nasal root area. Rarity of this condition makes clinical level diagnosis a challenge. Differential diagnoses for NGH are dermoid cyst, encephalocoele, hemangioma, allergic nasal polyp, or chronic otitis media. NGH has no direct communication with intracranial cavity, unlike an encephalocoele. However, potential intracranial connection is possible, through cribriform plate or bony deformities. Therefore, pre-operative aspiration and biopsies are contraindicated in childhood swellings in forehead/nasal bridge area. Instead, pre-operative imaging modality investigations are mandatory. It is also important to note the risk for the removal of functional brain tissue and also post-operative meningitis or cerebrospinal fluid rhinorrhea. A 1-year-old female child presented with a mass on nasal bridge. Overlying skin was unremarkable. Swelling did not increase in size on coughing. Diagnosis: Dermoid cyst/encephalocoele. Computed tomography (CT) scan investigation: CT scan confirmed the diagnosis of nasal encephalocoele > nasal dermoid. The mass was excised. Histopathology (histopathological examination [HPE]): The excised specimen was a single, unencapsulated, ovoid, and soft to firm, yellow-colored tissue bit, measuring 2.5 cm × 2 cm × 1 cm. On cut section, there were no cystic areas/spongy appearance/mucoid bits. Hematoxylin and eosin-stained sections revealed a poorly circumscribed mass, showing a population of cells with ovoid or irregular nuclei and a fibrillary stroma-resembling cerebral and glial tissue. These were arranged in a disorganized fashion and were surrounded by fibrous tissue and few skeletal muscle fibers. All HPE findings point toward the diagnosis of NGH. It is important to consider NGH as a differential, in case of childhood swellings in the forehead and nasal root region. Histopathology remains the gold standard for diagnosis.
Heterotopic brain in the parapharyngeal space
International Journal of Pediatric Otorhinolaryngology, 1996
There have been numerous reports of various types of heterotopic tissue in the head and neck. Heterotopic cartilage, gastric tissue, thyroid, and salivary gland in such various locations as tongue, gingiva, palate, nasopharynx, parapharyngeal space, and neck have been frequently reported. Heterotopic brain in the parapharyngeal space causing airway obstruction in the neonate has been rarely described. These benign masses are capable of expansion and because of their location, can lead to significant airway and feeding difficulties. We describe 3 cases of heterotopic brain tissue in the parapharyngeal space causing feeding difficulties and airway obstruction in the neonatal period. Two were initially misdiagnosed as lymphatic malformations. In the third, a nine month delay in diagnosis occurred. The diagnostic features of heterotopic brain in this location and some management suggestions in treating such a lesion are discussed.
Nasal heterotopy in a Newborn Infant: A Case Report
The Journal of Pediatric Research, 2018
Glial heterotopias are rare, congenital, benign, midline, non-teratomatous extracranial glial tissues which are mostly present in the nose and may masquerade as encephalocele or dermoid cyst. These masses appear to share a similar embryogenic origin. Herein, we present a neonatal nasal glioma on the nasal root and glabella area. Although rare, because of their potential to connect to the central nervous system, these disorders are clinically important.
Sao Paulo Medical Journal, 2010
CONTEXT: Neuroglial ectopia has been defined as a mass composed of differentiated neuroectodermal tissue isolated from the spinal canal or cranial cavity and remains rare. This lesion has to be considered in the differential diagnosis among newborn infants with classical symptoms of respiratory distress, neck mass and feeding difficulties. We present a rare case of extensive parapharyngeal and skull base neuroglial ectopia in 6-month-old girl who presented respiratory and feeding obstruction at birth. CASE REPORT: A six-month-old girl who presented upper respiratory and feeding obstruction at birth and was using tracheostomy and gastrostomy tubes was referred to our institution. Complete surgical excision of the mass consisted of a transcervical-transparotid approach with extension to the infratemporal fossa by means of a lateral transzygomatic incision, allowing preservation of all vital neurovascular structures. The anatomopathological examination showed a solid mass with nests of...
Heterotopic Neuroglial Tissue Causing Upper Airway Obstruction in A Newborn
2000
Heterotopic neuroglial tissue, composed of differentiated neuroectodermal tissue, represents developmental heterotopia of neuroglial tissue rather than true neoplasm. Herein, we present a patient with nasopharyngeal heterotopic neuroglial tissue who presented with respiratory distress and feeding difficulty in early days after birth. Magnetic resonance imaging showed a cystic lesion measuring about 3 × 1.5 cm in the nasopharynx near the uvula.
Dermatopathology, 2021
Background: neck cysts are frequently encountered in pediatric medicine and can present a diagnostic dilemma for clinicians and pathologists. Several clinical items enable to subclassify neck cyst as age at presentation, anatomical location, including compartments and fascia of the neck, and radiological presentation. Summary: this review will briefly describe the clinical, imaging, pathological and management features of (I) congenital and developmental pathologies, including thyroglossal duct cyst, branchial cleft cysts, dermoid cyst, thymic cyst, and ectopic thymus; (II) vascular malformations, including lymphangioma. Key Messages: pathologists should be familiar with the diagnostic features and clinicopathologic entities of these neck lesions in order to correctly diagnose them and to provide proper clinical management.
Congenital tumours involving the head, neck and central nervous system
Pediatric Radiology, 2009
Congenital intracranial tumours are uncommon and differ from those occurring in older children in clinical presentation, imaging characteristics and prognosis. These tumours are often detected incidentally on routine prenatal US and/or fetal MRI. Hence, the paediatric radiologist should be familiar with the features of those lesions that should be included in the differential diagnosis. In general, the prognosis of these conditions is poor owing to large tumour size and the limitations of adjuvant therapy at such a young age. Congenital lesions involving the head and neck region require a meticulous imaging approach using both US and MRI techniques to better guide prenatal planning and fetal or neonatal surgical procedures.