Nasal Glioma Research Articles

A rare case of nasal glioma in the sphenoid sinus of an adult presenting with meningoencephalitis

Nasal gliomas are rare embryologic development defects that commonly present shortly after birth. Very few cases have ever been reported in adults. Of those presenting in adult life, most were casual findings in patients with no symptoms. Rare localizations have been described in the nasopharynx, soft palate, orbital cave and scalp. We present an unusual case of a 56-year-old man who initially presented with meningoencephalitis and was found to have nasal glioma in the sphenoid sinus. Having discussed their embryology and histology, we conclude that MRI scanning is the preferred method of investigation. However, radiological evaluation preoperatively should not lead to any sense of security if no bony defect (and thus, the possibility of intracranial extension) is demonstrated. Extirpation via a functional surgical approach is the treatment of choice to prevent deformities in the facial bones. This can range from direct incision over the gliomata to removal transnasally by endoscopy or using a lateral rhinotomy approach depending on the location, size and involvement of the glioma.

Orbital ectopic glial tissue in relation to medial rectus: a rare entity

Heterotopic brain tissue is a rare entity and it is rarer still in the orbit. There have been very few case reports of orbital ectopic glial tissue. The case is described herein of a 3-month-old baby presenting with an orbital glial hamartoma inseparable from the medial rectus muscle. The diagnosis was based on the histopathological features and a positive GFAP stain. The features of this case and the previously reported cases are discussed.

Heterotopic central Nervous tissue - nasal glioma : A case report

Heterotopic central Nervous tissue - nasal glioma : A case report

Endoscopic management of the intranasal glioma

The authors report the endoscopic management of a boy with nasal glioma who was only 35 days old. The nasal glioma is a rare congenital nasal abnormality, which manifests as a mass of extracranial cerebral tissue unconnected with the brain. For surgical excision, some surgeons suggest initial craniotomy for excluding intracranial extension. The authors successfully removed the intranasal glioma by endoscopic surgery without craniotomy on a 35-day-old boy. Intranasal endoscopic surgery is a less-invasive and safe procedure and does not result in postoperative facial scarring and deformity. Therefore, the use of endoscopic surgery in place of lateral rhinotomy procedure is recommended.

Nasal Glioma

Nasal Glioma

Nasal glioma and encephalocele: diagnosis and management.

To review the biology of nasal glioma and encephalocele and to present an algorithm for preoperative evaluation and surgical management. Retrospective review and analysis. Tertiary care medical center: 1970 to 2002. Sixteen patients with glioma (n = 10) and encephalocele (n = 6). Age at the time of presentation, sex, signs and symptoms, imaging findings, surgical approach, pathology, complications, rate of recurrence, and follow-up were recorded. Ten patients presented with nasal glioma with a mean age of 9 months. All patients underwent surgical excision. No complication was encountered with a mean follow-up of 3.5 years. Six patients presented with encephaloceles with a mean age of 15.5 months. All patients underwent surgical excision. Complications included cerebrospinal fluid leak (n = 1) and epiphora (n = 1). Follow-up was 1 to 14 years (mean, 4 years). Nasal glioma and encephalocele are rare, benign, congenital lesions with a potential for intracranial extension. Evaluation should include a complete rhinologic and neurologic examination. Preoperative imaging with a thin-cut axial and coronal computed tomography scan and/or multiplanar magnetic resonance imaging is essential. Surgical intervention should be performed soon after diagnosis to alleviate the increased risk of meningitis. A frontal craniotomy approach is recommended if intracranial extension is identified based on preoperative evaluation, followed by an extracranial resection. If there is no evidence of intracranial extension, a conservative extracranial approach is recommended.

Nasal glial heterotopia: a clinicopathologic and immunophenotypic analysis of 10 cases with a review of the literature.

Nasal glial heterotopia (also known as "nasal glioma"), is a rare developmental abnormality seen in a wide age group but typically presenting at birth or in early childhood. Failure to recognize the entity is the principle difficulty in diagnosis. Ten cases of nasal glial heterotopic diagnosed between 1970 and 2000 were identified. Histologic and immunohistochemical features were evaluated and patient follow-up was obtained. The patients included five females and five males with a mean age at presentation of 8.6 years (range, birth to 44 years). Most patients presented clinically with a polypoid mass in the nasal cavity, although two patients had a mass on the nasal bridge. Symptoms were present for an average of 2 to 3 months. A connection to the central nervous system was identified in one case. Masses ranged in size from 1 to 7 cm in greatest dimension (mean, 2.4 cm). Histologically, the masses were composed of astrocytes (including gemistocytic type) and neuroglial fibers intermixed with a fibrovascular connective tissue stroma. Neurons and ependymal cells were noted in two cases. Focal calcifications and inflammatory cells were identified occasionally. Masson trichrome stains the collagen intensely blue, while the neural population stains magenta. Immunohistochemical reactivity with glial fibrillary acidic protein and S-100 protein will help to confirm the histologic diagnosis, while collagen type IV and laminin can highlight the reactive fibrosis. All cases were managed by surgery. All patients were alive without complications at last follow-up (mean, 26.8 years), except for the single fetus included in the study. Nasal glial heterotopia typically involves the nasal cavity and usually presents perinatally, although three patients presented in adulthood. The subtle glial component on routine microscopy can be accentuated with a trichrome stain or by immunoreactivity with glial fibrillary acidic protein and S-100 protein. Imaging studies must be performed before surgery to exclude an encephalocele, which requires different surgery. Complete surgical excision of nasal glial heterotopias is curative.

Nasal glial heterotopia: a clinicopathologic study of 10 patients

Nasal glial heterotopia, also known as nasal glioma, is a rare developmental anomaly of the nasal cavity occurring in patients over a wide range of ages, with a predilection for presentation at birth or in early childhood. Failure to recognize the entity is the principal difficulty in diagnosis. Ten patients with nasal glial heterotopia diagnosed between 1970 and 2000 were identified in the files of the Armed Forces Institute of Pathology. Microscopic and immunohistochemical features were evaluated, and patient follow-up data were obtained. The patient group consisted of 5 females and 5 males with a mean age at presentation of 8.6 years (range, birth-44 years of age). Three patients were adults. Most patients presented clinically with a polypoid mass in the nasal cavity, but 2 had a mass on the nasal bridge. Symptoms were present for 2 to 3 months. Anatomic connection to the central nervous system was identified in 1 patient. The masses ranged from 1 cm to 7 cm at the greatest dimension (mean, 2.8 cm). Microscopically, the masses were composed of astrocytes, including gemistocytic forms, and neuroglial fibers mixed with a fibrovascular connective tissue stroma. Neurons and ependymal cells were noted in 2 patients. Focal calcifications and inflammatory cells were occasionally identified. A Masson trichrome stain produced intense blue collagen staining, with the neural population appearing magenta. Immunohistochemical reactivity with glial fibrillary acidic protein and S-100 protein aided in confirming the diagnosis, whereas the presence of type IV collagen and laminin highlighted the reactive fibrosis. All patients were managed with surgery. With the exception of a single fetus included in the study, all patients were alive without complication after a mean follow-up period of 26.8 years. Imaging studies must be performed before surgery to exclude an encephalocele. Complete surgical excision of nasal glial heterotopia is curative.

Glioma nasal: relato de três casos e revisão de literatura

Glioma Nasal é uma malformação congênita rara, benigna e diagnosticada habitualmente logo após o nascimento, que requer tratamento precoce para evitar deformidades faciais. São relatados três casos de pacientes com diagnóstico de Glioma Nasal em acompanhamento no Departamento de Otorrinolaringologia do Hospital das Clínicas da Faculdade de Medicina da USP, com descrição, para cada caso, dos exames subsidiários, do tratamento empregado e de sua evolução. O primeiro caso é do sexo feminino, que apresentava uma massa sólida que se exteriorizava pela fossa nasal esquerda. O segundo paciente era do sexo masculino e apresentava uma fenda palatina por onde se exteriorizava uma massa ocupando a cavidade oral. O terceiro paciente era do sexo masculino e apresentava uma tumoração em dorso nasal. Após a ressecção cirúrgica, todas as peças mostravam glioma nasal. Massas congênitas de Linha Média Nasal podem representar uma lesão de difícil diagnóstico antes do estudo histopatológico, porém não se deve poupar esforços para fazer o diagnóstico correto, proporcionando assim um prognóstico acurado e uma programação cirúrgica apropriada.

Endoscopic Excision of A Nasal Glioma

Unilateral nasal mass is a fairly rare presentation in the paediatric age group. The common differential diagnosis include antrochoanal polyps, dermoid cysts, teratomas, encephaloceles and nasal gliomas. A diagnosis is usually obtained with the aid of imaging techniques such as Computed Tomography and Magnetic Resonance Imaging, Nasal gliomas are usually treated by complete excision. We report a case in which the nasal glioma was excised endoscopically.

MR of a nasal glioma in a young infant. A case report

We describe MR findings of a nasal glioma in a 5-week-old male infant with feeding difficulties and symptoms of respiratory distress. Endoscopic examination revealed a soft tissue mass in the nasal cavity. In T1- and T2-weighted images, the gyral structure of grey matter was visible. In T1-weighted images, a tissue component with a lower signal intensity equal to that of white matter was also well distinguishable. Edge enhancement of the tumour was due to the nasal mucosal epithelium covering the tumour. MR images were useful to rule out intracranial extension of the nasal cavity lesion and the brain, thus excluding the diagnosis of encephalocele. The lesion was excised and histologically characterized as heterotopic brain tissue.

Nasal Glioma: A Case Report

Nasal gliomas are rare, benign, congenital tumors that are thought to be the result of an abnormality in embryonic development. Three types of clinical presentations have been recognized: extranasal (60%), intranasal (30%), and combined (10%). Clinically, these masses are firm, noncompressible, nonpulsatile, gray or purple lesions that obstruct the nasal cavity intranasally and cause deformity extranasally. Histologically, these tumors are made up of astrocytic neuroglial cells interlaced with fibrous and vascular connective tissue that is covered with skin or nasal respiratory mucosa. The preferred treatment is excision via a frontal craniotomy approach for those patients whose gliomas have an intracranial connection, for those patients who have cerebrospinal fluid rhinorrhea, and for those who have recurrent episodes of meningitis. Otherwise, a transfacial lateral rhinotomy is advised. In this article, we describe a case of a nasal glioma that was removed via a lateral rhinotomy.

Endoscopic surgery for the removal of a nasal glioma: Case report

Otolaryngol Head Neck Surg 2001;124:690.

A case of nasal glioma in a new-born infant

We report a 1 day old girl with a nasal mass that was diagnosed as an intranasal glioma. The tumor mass was noted to be localized laterally from, and based along, the inferior turbinate. Nasal glioma is a developmental abnormality of neurogenic origin with no malignant potential. An intranasal mass requires careful rhinological, neurological and radiological examinations. With adequate initial removal, excisional biopsy usually allows complete recovery. A frontal craniotomy approach is preferred for those patients who have nasal glioma with an intracranial connection. With no evidence of an intracranial connection, a conservative extracranial approach is recommended.

Nasal glioma presenting as blindness in an adult

Nasal gliomas are rare, benign, congenital, midline tumors. They are seen most commonly in neonates and children but rarely in adults. We encountered in a 28-year-old woman a rare case of nasal glioma presenting as bilateral total blindness. The tumor was present in both nasal fossae. It extended into the parasellar region, with erosion of the cribriform plate and medial wall of the right orbit.

Nasal encephaloceles

Nasal encephaloceles can be divided into frontoethmoidal and basal encephaloceles. Both conditions are very rare, but frontoethmoidal encephaloceles show a relatively high incidence (1:5,000) in Southeast Asia. The pathogenesis of encephaloceles may be explained by a disturbance in separation of surface ectoderm (epithelial layer) and neurectoderm (nervous tissue) in the midline just after closure of the neural folds. It should be regarded as a 'late' neurulation defect taking place during the 4th gestational week. Apoptosis appears to be related to this separation process. Frontoethmoidal encephaloceles can be recognized as a facial mass covered with normal skin, while basal encephaloceles may cause nasal obstruction or symptoms related to herniation of basal structures. Diagnostic CT or MR imaging delineates the anatomy of the herniated mass. Therapy for frontoethmoidal encephaloceles consists in excision of the cele, watertight closure of the dural defect and reconstruction of the skull defect. Basal encephaloceles may harbour vital herniated structures which should be saved. Hydrocephalus should be dealt with first, followed by elective single-stage reconstructive surgery. The prognosis appears to be better for patients with frontoethmoidal encephaloceles than for patients with occipital or parietal encephaloceles, and it depends largely on the presence of additional congenital anomalies of the brain. The differential diagnosis of a nasal mass must include nasal glioma, dermoid cyst, and nasal polyp.

Midface anomalies in children.

A variety of congenital midface anomalies occur in children. High-resolution computed tomography (CT) and magnetic resonance (MR) imaging have proved helpful in determining the nature and extent of dysplasia, thereby facilitating treatment planning. A classification system has been developed that groups these anomalies into four categories based on embryogenesis and anatomic location. These categories comprise anomalies that are related to the nasal cavity, nasofrontal region, nasolacrimal apparatus, and craniofacial syndromes. CT is the imaging modality of choice in children with possible choanal atresia, pyriform aperture stenosis, or anomalies of the nasolacrimal duct (eg, nasolacrimal duct stenosis, dacryocystoceles). MR imaging is the modality of choice in patients with congenital midface masses (eg, dermoid and epidermoid cysts, nasal gliomas, encephaloceles) and craniofacial syndromes (eg, Apert syndrome, Crouzon syndrome, Treacher Collins syndrome). In many cases, however, both CT and MR imaging are required to adequately evaluate midface anomalies. Familiarity with the characteristic imaging features of these anomalies along with knowledge of midface embryogenesis and normal developmental anatomy is essential to prevent misinterpretation of anatomic variations that may simulate disease.

Relapsing nasal glioma in a three-week-old infant

Relapsing nasal glioma in a three-week-old infant

Relapsing nasal glioma in a three-week-old infant

Relapsing nasal glioma in a three-week-old infant

Endoscopic management of nasal glioma in infancy

In the surgical treatment of nasal glioma, craniotomy has been recommended for excluding the possibility of intracranial extension of the lesion. We describe a case in whom intranasal glioma was successfully removed by endoscopic surgery without craniotomy at 4 months old. Intranasal endoscopic surgery is considered appropriate for the removal of intranasal glioma having no intracranial extension, since the procedure is less invasive and does not result in postoperative facial deformity. Intranasal endoscopic surgery is also proposed as the preferable procedure to craniotomy for excluding intracranial extension of intranasal glioma.