Heterotopic brain cyst from middle cranial fossa to submandibular region

Unilateral Anophthalmia and Congenital Frontal Cranioschisis Associated with Extradural Neuroglial Heterotopia: new Insights into a Possible New Malformative Spectrum

Background: Neuroglial heterotopia, characterized by mature -neuroglial tissue outside the central nervous system, has not been previously associated with cranioschisis. Case Report: A 4-year-old female patient, with left congenital anophthalmia, had a nasofrontal neuroglial heterotopia protruding through an ossification defect. Discussion: Nasofrontal cranioschisis may be associated with neuroglial heterotopias. The combination of anophthalmia and neuroglial heterotopia, previously described only once in the literature, may be part of a broader malformation spectrum that has not been properly characterized to date.

Neuroglial ectopia of the vestibular nerve masquerading as a vestibular schwannoma: A case report

Neuroglial ectopia is a rare entity of undetermined clinical significance. Here, we report a unique case of neuroglial ectopia of the vestibular nerve. A 27-year-old pharmacy student with a previous radiological diagnosis of vestibular schwannoma presented to our clinic for surgical evaluation. Magnetic resonance imaging (MRI) of the brain revealed a 17-mm T1 hypo- to isointense, T2 iso- to hyperintense, poorly enhancing left cerebellopontine angle mass extending into the left internal auditory canal compatible by imaging with a vestibular schwannoma. The lesion was resected under MRI guidance. The frozen specimen came back as a benign hypocellular lesion. Histological assessment revealed a peripheral nerve engulfed by glial fibrillary acidic protein-positive, S-100-negative cells, suggestive of neuroglial ectopia. There was no evidence of schwannoma. The main concerns were benign neoplasm with potential for progression or sampling artifact. The patient had an uncomplicated hospital course. This case report demonstrates an unusual case of neuroglial ectopia of the vestibular nerve. The differential diagnoses for a poorly enhancing cerebellopontine angle mass should include neuroglial ectopia.

Case series of congenital heterotopic neuroglial tissue in the parapharyngeal space

Cases of congenital heterotopic tissue presenting in the head and neck are frequent in the pediatric otolaryngology literature. Heterotopic glioneuronal tissue is rare and fewer than 20 cases of heterotopic glioneuronal tissue in the parapharyngeal space have been reported. We present two cases of infant children who were seen at the Children's Hospital of Pittsburgh in 2013 with glioneuronal heterotopic masses in the parapharyngeal space.

Ectopic glioneuronal tissue in the middle cranial fossa region. Report of four cases

The growth of ectopic glioneuronal tissue in the middle cranial fossa region is an uncommon event, with very few cases reported in the literature. In this paper the authors document 4 cases of ectopic glioneuronal tissue in the middle cranial fossa in children and briefly describe the clinical course and pathology. All of the children presented within the first 6 months of life. Two children presented with facial masses, 1 with airway obstruction, and another with proptosis of the right eye. Each child underwent a customized surgery dependent on the location and characteristics of the harbored lesion. Ectopic glioneuronal masses in the middle cranial fossa are rare and benign congenital tumors, and affected newborns can present with airway obstruction, feeding difficulties, and facial deformity depending on the lesion location. Determining an appropriate surgical approach and strategy is a significant challenge and may involve a multidisciplinary team of craniofacial plastic surgeons, otolaryngologists, and neurosurgeons. Although these lesions share clinical and anatomical similarities, because of their histopathological heterogeneity, it is unlikely that they represent a single pathological entity. The long-term outcome in these children is still unknown and is an area for future study. The pathogenesis of these lesions also remains unknown and may be revealed in future research.

Anterior cranial base glioneuronal heterotopia

BACKGROUND

Cranial base glioneuronal heterotopia is a nest or linear array of glioneuronal tissue within the basal meninges. It is thought to arise from aberrant migration of embryonic neuroepithelial tissues into the subarachnoid space. It frequently mimics tumors and may extend through basal skull bones into extracranial soft tissues.

CASE REPORT

We describe a case of intracranial anterior skull base leptomeningeal glioneuronal heterotopia in a newborn female who was diagnosed in the prenatal period by ultrasound examination to have an intracranial space-occupying lesion at 35 weeks of gestation. There was no evidence of increased intracranial pressure at birth. Magnetic resonance imaging showed a large, predominantly solid, minimally enhancing tumor in the anterior cranial fossa extending into the suprasellar region as well as into the right and left middle fossae. The gross tumor was totally resected through bifrontal craniotomy.

CONCLUSIONS

Although uncommon, diagnosis of intracranial extracerebral glioneuronal heterotopia should be strongly ascertained while evaluating intracranial space-occupying lesions during the prenatal period and infancy. It needs to be distinguished histologically from teratoma and primary central nervous system tumors. Prenatal screening for early diagnosis of the lesion is vital. The location of the lesion and its relationship to the surrounding structures should lead to an accurate diagnosis in the majority of cases. Complete resection is curative and should be the goal. Long-term prognosis is excellent in view of the benign nature and extraaxial origin of the lesion.

Cerebral heterotopia of the temporofacial region. Case report

The authors report a case of cerebral heterotopia in the right temporofacial region of a neonate. The lesion presented as a massive cystic swelling containing cerebrospinal fluid. It produced calvarial and facial bone deformities. After the mass was excised, histological examination revealed glial tissue and choroid plexus.

Heterotopic brain in the parapharyngeal space

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.

Endoscopic treatment of an oral cephalocele. Case report

This report describes an unusual cephalocele originating in the temporobasal region and protruding through the sphenopetral area into the oral cavity. A rapid and nonaggressive endoscopic procedure was performed. The relationship between this type of cephalocele, spontaneous anteroinferior temporal encephaloceles, and nasopharyngeal brain heterotopia is discussed.

Spontaneous temporal encephalocele. Case report

The authors report a 36-year-old woman with a 23-year history of simple and complex partial seizures who was treated surgically for an anteroinferior temporal encephalocele, with resolution of the seizure disorder. This patient's presentation, findings, and response to treatment are typical of those associated with anteroinferior temporal encephalocele, and different from the clinical patterns of four other types of spontaneous temporal encephalocele.

Subcutaneous nodules of the scalp: preoperative management

The differential diagnosis of subcutaneous lesions of the scalp is extensive and includes many tumors with intracranial and intraosseous extension. The vast majority of lesions seen by the dermatologist will be benign. However, certain lesional characteristics increase the likelihood of a serious disorder and these must be evaluated preoperatively. We review the important features of subcutaneous scalp lesions and suggest a systematic approach to diagnosis based on patient age, lesion morphology, location, and radiographic findings.