Abstract
Objective: This paper reports a rare case of nasal glial heterotopia presenting as sphenochoanal polyp. So far, literature has revealed only few cases. Case Report: A 55-year-old woman presented with a 2-month history of left sided nasal obstruction. Rigid endoscopy showed greyish left nasal polyp and anterior discharge. Subsequently, CT scan of the sinuses revealed sphenochoanal polyp filling the left nasal cavity, without signs of expansion, or destruction and no obvious connection with intracranial tissue. Mass was removed endoscopically and histology confirmed glial nature of the mass. Conclusion: Any mass arising from sphenoid sinus should be carefully evaluated on CT scan for existence of fibrous stalk, or connection with brain tissue and needs to be considered in the differential diagnosis of the sphenochoanal mass. Complete surgical excision is the treatment of choice, which is curative.
Highlights
Nasal Glial Heterotopias (NGH) are congenital tumours of the midline frontonasal space arising from a normal neurectodermal tissue entrapped during the closure of the anterior neuropore
NGH, or differentiated neural tissue outside the cranial vault is uncommon, and these anomalies most commonly occur in the nasal cavity [1] [2]
The biggest challenge in the diagnostic process is the differentiation between encephalocele, which typically presents with marked connection between the mass and the intracranial tissue
Summary
Nasal Glial Heterotopias (NGH) are congenital tumours of the midline frontonasal space arising from a normal neurectodermal tissue entrapped during the closure of the anterior neuropore. The most common congenital nasal masses are nasal dermal sinus cysts, nasal encephaloceles, and NGH. These masses appear to share a similar embryogenic origin. NGH presenting as sphenochoanal mass are rare. Mixed form (10%) associates both extranasal and intranasal extensions [5]. They are composed of astrocytes and neuroglial fibers intermixed with a fibrovascular connective tissue stroma. Rare neurons and/or ependymal cystic structures may be present as well. The objective of this paper is to raise awareness of this rare congenital tumour, which should take part in differential diagnosis of all unilateral solitary sphenoidal lesions
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