Nasal glial heterotopia – Clinical manifestation in 2.5 month-old boy

Abstract

Nasal glial heterotopia is a rare congenital defect that is formed during embryological development. This lesion is part of a larger group of diseases, congenital midline nasal tumors, that occur with a frequency of once per 20,000-40,000 live births. Histologically, nasal glial heterotopia is a concentration of glial tissue which exhibits no malignant potential. We can differentiate three basic types of the disease based on the location of the lesion: 60% of nasal gliomas are extranasal, 30% are intranasal and only 10% combine extra- and intranasal components. Because of the rare occurrence correct diagnosis is quite difficult. We present a case of 2.5-month male who was admitted to the Department of Pediatric Otolaryngology for the diagnosis and treatment of a tumor deforming the bridge of his nose. Initial differential diagnosis included encephalocele, glial heterotopia (nasal glioma), angioma, nasal dorsal cyst, rhabdomyosarcoma, lacrimal duct cysts. We performed endoscopic examination, radiological imaging (CT, MRI) and histological assessment of lesion. The patient was diagnosed with nasal glial heterotopia (extra-and intranasal) based on diagnostic studies and clinical manifestation. The resection of the lesion was performed by means of dual access, external and endoscopic. The results of surgical treatment are satisfactory, control endoscopy showed no residual tumor presence.