Heterotopic pharyngeal brain (original) (raw)
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Brain Heterotopia in Pharyngeal Region. A Morphological and Immunohistochemical Study
Pathology - Research and Practice, 2002
Pharyngeal brain heterotopia is a congenital and generally biologically benign lesion. In contrast to brain heterotopia in the nose, the most common site of this lesion, brain heterotopia in the pharynx is very rare. Pharyngeal heterotopic tissue can be composed of various components, i.e., astrocytes, neurons, ependyma or choroid plexus, oligodendrocytes, retina, and, occasionally, neoplastic nodules. In contrast, nasal lesions are often only composed of astrocytes. We report a case of brain heterotopia in the pharyngeal region, diagnosed in a newborn female infant, causing serious respiratory distress. The infant underwent surgical excision of the lesion, and after 1 year of follow-up, she is recurrencefree. The mass, about 3 cm in diameter and showing no connection with encephalic structures, was characterized by numerous papillary structures and areas containing stellate-like or spindle cells focally forming nodules. Moreover, there was inflammatory infiltration, whereas mitoses, hemorrhages, and necroses were absent. Immunohistochemistry revealed a choroid plexus nature of the papillary formations (S-100, cytokeratins, transthyretin and vimentin-positive) and the presence of glial and neuronal cells in the remaining areas (glial fibrillary acidic protein, neuron-specific enolase, neurofilaments, synaptophysin, and S-100 positive). This case report confirms that the presence of choroid plexus is not uncommon and that pharyngeal brain heterotopia is usually benign.
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.
Heterotopic Brain in the Pterygopalatine Fossa
2000
Summary: Heterotopic brain outside the cranial vault is uncom- mon. It occurs most frequently in the nasal region, although rests elsewhere in the aerodigestive tract have been reported. We describe a case of heterotopic brain in the pterygopalatine fossa.
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.
Journal of Medical Case Reports, 2011
Introduction: Neuroglial heterotopia, heterotopic brain tissue, or differentiated neural tissue outside the cranial vault is uncommon, and these anomalies most commonly occur in the nasal cavity. Case presentation: We report a case of rare pure cystic heterotopic brain tissue in a two-month-old Caucasian baby girl that presented as a large cystic neck mass and was confused with a cystic hygroma. Her mother reported a progressive increase in the size of this swelling and mild respiratory difficulty when the girl was sleeping. A computed tomography scan of the brain and neck showed a large heterogeneous mass extending from the base of the skull to the left submandibular region; a cystic component was also noted. Our patient under went total excision of the cystic mass and prevention of airway obstruction by a left submandibular approach. The final gross pathology diagnosis was heterotopic brain tissue. Conclusions: Pure cystic neck heterotopic brain tissue lesions are very uncommon, and a preoperative diagnosis of this lesion is difficult. Brain heterotopia is a rare, benign condition that should be considered in the differential diagnosis of the neonatal head and neck mass.
The Cleft Palate-Craniofacial Journal, 2006
Objective A large excrescence was found bulging from the mucoperiosteum of the nasopharynx in a neonate displaying abnormal craniofacial features. The aim of this study was to determine the nature of this tissue mass. Design Histological examination of this mass of tissue and the surrounding nasopharyngeal mucosal tissue, as well as tissue located in the sella turcica of the sphenoid bone, were carried out. In addition, tissue in a canal connecting the large mass to the sella turcica was removed for analysis. Results Nervous elements and adenohypophyseal tissue were histologically identified in the large excrescence, but were separate from adenohypophyseal tissue of the pharyngeal hypophysis. Both structures were located in the mucoperiosteum of the nasopharynx. Conclusions The large tissue mass found in the nasopharynx is histologically identical to a sellar hypophyseal gland, but differed from the adjacent pharyngeal hypophysis in histological composition. The mass, although sella...
Parapharyngeal neuroglial heterotopia in Pierre Robin sequence: MR imaging findings
International journal of pediatric otorhinolaryngology, 2009
Heterotopic neuroglial tissue is a rare lesion, occurring more frequently in the nasal cavities. Other rare locations are the orbit, the scalp, the palate, the pharynx, the parapharyngeal space and the lungs. They are usually detected occasionally because they are often asymptomatic, but sometimes they might present with dyspnoea, feeding difficulty, snorting and nasal flaring. Respiratory symptoms occur when heterotopic neuroglial tissue is located in the parapharyngeal space. We report a case of an infant affected by Pierre Robin sequence (PRS) who was admitted to our Institution for a worsening respiratory distress that was not explainable only by PRS.
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.