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Dini M, Lo Russo G, Colafranceschi M. So-Called Nasal Glioma: Case Report with Immunohistochemical Study. TUMORI JOURNAL 2018; 84:398-402. [PMID: 9678625 DOI: 10.1177/030089169808400317] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The so-called nasal gliomas (nasal cerebral heterotopias) are rare, congenital, benign masses of neurogenic origin with intra or extranasal location, or both. An intranasal case is reported in a 7-month-old infant who successfully underwent surgery with the intranasal approach. The tumor had no intracranial extension and the child is free of disease after a three-year follow-up. Immunohistochemical study confirmed the glial (GFAP+) and neuronal (NSE+) nature of the cells composing the mass. In addition to the clinical behavior, the benign nature of the tumor is also indicated by the negativity of Ki67 (MIB-1) and p53 proliferation markers as well as by CD44 negativity. As far as we know, this is the first reported case of nasal glioma subjected to immunohistochemical investigation of proliferation activity.
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Affiliation(s)
- M Dini
- Cattedra di Chirurgia Plastica e Ricostruttiva, Università degli Studi di Firenze, Florence, Italy
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2
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Naidich T, Braffam B, Altman N, Birchansky S. Congenital Malformations Involving the Anterior Cranial Fossa. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140099400700304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - B.H. Braffam
- Department of Radiology, Memorial Hospital; Hollywood FL
| | - N. Altman
- Department of Radiology, Miami Children's Hospital
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3
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Abstract
BACKGROUND Nasal gliomas are congenital neurogenic tumours that are mostly diagnosed in the perinatal period. They occur in 1 in 20 000-40 000 live births. Cases reported in adulthood are rare and the management in adults is controversial. CASE REPORT A 55-year-old female had an incidental diagnosis of nasal glioma after routine endoscopic sinus surgery and polypectomy. Post-operatively, there was symptomatic improvement, but it was complicated by a cerebrospinal fluid leak. CONCLUSION Most adults who present with nasal gliomas have non-specific nasal symptoms, and diagnosis is made from an incidental finding of heterotopic glial tissue. The management of nasal gliomas in adults is contentious. In contrast, management in the paediatric population is better established and the treatment is surgical excision. The relevant literature is reviewed.
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4
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Abstract
This paper focuses on the diagnosis and management of developmental anomalies of the skin that may be seen early in life. Common locations include the head, nose, preauricular area of the face, neck, and spine. Those that occur in or near the midline can be more serious because of possible intracranial connections. Radiologic imaging of the areas of involvement is often important; computed tomography (CT) scans can delineate bony defects; whereas, magnetic resonance imaging (MRI) more clearly defines intracranial connections. Occult spinal dysraphism can be suspected when certain cutaneous signs are present.
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Affiliation(s)
- Jane Sanders Bellet
- Departments of Dermatology and Pediatrics, Duke University Medical Center, Durham, NC, USA.
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5
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Ramadass T, Narayanan N, Rao P, Parameswaran A. Glial Heterotopia in ENT-Two Case Reports and Review of Literature. Indian J Otolaryngol Head Neck Surg 2011; 63:407-10. [PMID: 23024956 DOI: 10.1007/s12070-011-0267-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2009] [Accepted: 04/27/2011] [Indexed: 11/30/2022] Open
Abstract
The purpose of presenting these case reports is to highlight the occurrence of heterotopic glial tissue of the tongue and nose in children. So far, literature review has revealed few case reports of such lesions in neonates, but our patients presented with this unique lesion at the age of two and a half years and 3 years. This is a rare congenital anomaly in the tongue, which can mimic a lingual thyroid, teratoma, dermoid cyst etc. Surgical excision is mandatory when the lesion causes obstructive symptoms. The authors discuss the problems in diagnosis, pathology and management and review the literature.
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Affiliation(s)
- T Ramadass
- Department of Otolaryngology and Head & Neck Surgery, Apollo Hospitals, Greams Lane, Chennai, 600 006 India
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6
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Adult nasal glioma presenting with visual loss. The Journal of Laryngology & Otology 2010; 124:1309-13. [PMID: 20178676 DOI: 10.1017/s0022215110000022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES We report a rare case of a nasal glioma found incidentally in an adult, presenting with visual loss, optic nerve oedema and proptosis. CASE REPORT A 41-year-old woman presented with bilateral proptosis, impairment in visual acuity (6/60 bilaterally) and loss of colour vision. Computed tomography and magnetic resonance imaging showed proptosis, bilateral optic nerve swelling and a heterogeneous mass occupying the left nasal cavity and extending through a skull base defect into the anterior cranial fossa. Biopsy confirmed a nasal glioma. Treatment with intravenous dexamethasone resolved the proptosis, and the patient's visual acuity recovered to 6/9 bilaterally. At the multidisciplinary team meeting, it was felt that the nasal glioma probably represented an incidental finding and was not directly responsible for the patient's proptosis and transient visual loss. CONCLUSION To our knowledge, this is the first report in the English language literature of adult nasal glioma presenting with visual loss. The management of nasal gliomas in adults is contentious and the relevant literature is reviewed. This case was managed conservatively with regular follow up.
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7
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Dabholkar JP, Sathe NU, Patole AD. Nasal glioma- a diagnostic challenge. Indian J Otolaryngol Head Neck Surg 2004; 56:27-8. [PMID: 23120021 PMCID: PMC3451982 DOI: 10.1007/bf02968767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
In this unusual case there was a difficulty in diagnosis on the basis of histopathological reporting. On the grounds of clinical suspiscion one has to try to find out the proper diagnosis by advanced diagnostic methods like immunohistochemistry.
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Affiliation(s)
- J P Dabholkar
- Dept. of ENT, B.Y.L.Nair Ch. Hospital and T.N.Medical College, 10,Sudha, 20 Napean Sea Road, 400 036 Mumbai
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8
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Jartti PH, Jartti AE, Karttunen AI, Paakko EL, Herva RLO, Pirila TO. MR of a nasal glioma in a young infant. A case report. Acta Radiol 2002. [DOI: 10.1034/j.1600-0455.2002.430206.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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9
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Posnick JC, Costello BJ. Dermoid cysts, gliomas, and encephaloceles: evaluation and treatment. Atlas Oral Maxillofac Surg Clin North Am 2002; 10:85-99. [PMID: 12087868 DOI: 10.1016/s1061-3315(01)00004-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The fronto-orbitonasal malformations of encephaloceles, dermoid sinus cysts, and gliomas represent a continuum of neuroectodermal anomalies. The differentiation between them and other similar-appearing lesions is essential for effective management to proceed. Obtaining a reliable history, completing a careful physical examination, and obtaining accurate radiographic documentation represent the first steps. Establishing the timing, staging, and specific surgical techniques for management of a fronto-orbitonasal encephalocele remains as much an art as a science.
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Affiliation(s)
- Jeffrey C Posnick
- Departments of Plastic Surgery, Otorhinolaryngology/Head and Neck Surgery, Oral and Maxillofacial Surgery, and Pediatrics, Georgetown University School of Medicine, Washington, DC, USA
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10
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Uemura T, Yoshikawa A, Onizuka T, Hayashi T. Heterotopic nasopharyngeal brain tissue associated with cleft palate. Cleft Palate Craniofac J 1999; 36:248-51. [PMID: 10342613 DOI: 10.1597/1545-1569_1999_036_0248_hnbtaw_2.3.co_2] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The occurrence of extracranial brain tissue is rare. Most of the literature describes cases in which it is located around the nose and throat and has been classified as nasal glioma. Even more unusual is heterotopic brain tissue in the nasopharynx. We were able to find only 17 previously reported cases. Of these 17 cases, 6 had heterotopic brain tissue located in a cleft palate. This report comments on the identification and treatment of heterotopic brain tissue associated with cleft palate without connection to the central nervous system. Our case subject is a 10-month-old girl diagnosed with heterotopic nasophranygeal brain tissue associated with cleft palate. RESULTS Excision and palatoplasty were performed conjunctively with excellent results. CONCLUSIONS Simultaneous excision of heterotopic nasopharyngeal brain tissue and palatoplasty of the cleft palate is an excellent option for treatment of these cases.
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Affiliation(s)
- T Uemura
- Department of Plastic and Reconstructive Surgery, St. Mary's Hospital, Kurume, Japan.
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11
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Morita N, Harada M, Sakamoto T. Congenital tumors of heterotopic central nervous system tissue in the oral cavity: report of two cases. J Oral Maxillofac Surg 1993; 51:1030-3. [PMID: 8394899 DOI: 10.1016/s0278-2391(10)80050-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Affiliation(s)
- N Morita
- Department of Dentistry and Oral Surgery, Wakayama Medical College, Japan
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12
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Anand VK, Melvin FM, Reed JM, Parent AD. Nasopharyngeal gliomas: diagnostic and treatment considerations. Otolaryngol Head Neck Surg 1993; 109:534-9. [PMID: 8414575 DOI: 10.1177/019459989310900324] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Nasopharyngeal masses in newborns may produce life-threatening airway obstruction. Distinction between encephaloceles and gliomas is important for surgical planning, but cannot always be accurately assessed on the basis of high-resolution computed tomography or magnetic resonance imaging. Preoperative or intraoperative nuclide imaging or contrast injection studies may assist with selection of appropriate surgical approach.
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Affiliation(s)
- V K Anand
- Division of Otolaryngology, University of Mississippi Medical Center, Jackson 39216-4505
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13
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Horie N, Shimoyama T, Ozawa T, Ide F. Heterotopic brain tissue in the palate: case report. J Oral Maxillofac Surg 1991; 49:750-3. [PMID: 2056375 DOI: 10.1016/s0278-2391(10)80242-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- N Horie
- Department of Oral Surgery, Saitama Medical Center, Saitama Medical School, Japan
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14
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Kennard CD, Rasmussen JE. Congenital midline nasal masses: diagnosis and management. THE JOURNAL OF DERMATOLOGIC SURGERY AND ONCOLOGY 1990; 16:1025-36. [PMID: 2246408 DOI: 10.1111/j.1524-4725.1990.tb00327.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Congenital midline nasal masses (CMNMs) are rare lesions most commonly caused by dermoids, hemangiomas, nasal gliomas or encephaloceles. We report a case of nasal glioma and discuss the embryologic development, evaluation, and management of such CMNMs.
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Affiliation(s)
- C D Kennard
- Department of Dermatology, University of Iowa Hospitals and Clinics, Iowa City
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15
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al-Nafussi A, Hancock K, Sommerlad B, Carder PJ. Heterotopic brain presenting as a cystic mass of the palate. Histopathology 1990; 17:81-4. [PMID: 1699868 DOI: 10.1111/j.1365-2559.1990.tb00667.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
We report a case of heterotopic brain which presented as a cystic mass in the palate and which clinically was thought to be a cystic hygroma. Histologically, there was a remarkable proliferation of choroid plexus-like structures which we believe to have been responsible for the production of cerebrospinal fluid. We believe heterotopic brain to result from early displacement of multipotential cells and that the presence of cerebrospinal fluid within extracranial brain tissue does not imply an intracranial communication.
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Affiliation(s)
- A al-Nafussi
- Department of Pathology, University of Edinburgh, UK
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16
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Whittet HB, Barker S, Anslow P, Leighton S. Heterotopic brain tissue: a rare cause of adult recurrent meningitis. J Laryngol Otol 1990; 104:328-30. [PMID: 2370455 DOI: 10.1017/s0022215100112617] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Heterotopic brain tissue is a rare cause of symptoms in neonates in whom it may present with respiratory obstruction. In infants it may produce unilateral nasal obstruction due to a nasal 'polyp' or cerebrospinal fluid rhinorrhoea with an associated risk of meningitis. It is exceedingly rare in adults but may nevertheless be a cause of significant morbidity as this case demonstrates.
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Affiliation(s)
- H B Whittet
- E.N.T Department, Radcliffe Infirmary, Oxford
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17
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Puppala B, Mangurten HH, McFadden J, Lygizos N, Taxy J, Pellettiere E. Nasal glioma. Presenting as neonatal respiratory distress. Definition of the tumor mass by MRI. Clin Pediatr (Phila) 1990; 29:49-52. [PMID: 2293951 DOI: 10.1177/000992289002900108] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Nasal gliomas are benign congenital midline tumors with the potential for intracranial extension. They are most commonly seen in neonates and children but rarely in adults. The treatment of choice is surgical excision. Inadequate primary excision results in a 4 to 10 percent recurrence. Hence, a thorough preoperative evaluation is essential to delineate the exact site and extension of the tumor and to plan the appropriate surgical approach. Computerized tomographic (CT) scans are useful in visualizing bony defects, but are not well suited for soft tissue imaging. Magnetic resonance imaging (MRI) offers superior soft tissue contrast, without ionizing radiation. This is a report of a neonate with unexplained early respiratory distress. On day 5, a soft nasal mass became apparent. CT scans were inconclusive, so MRI scan was used to demonstrate intracranial extension. MRI is superior for imaging brain tissue, so it should be used preferentially to delineate intracranial extension and to help guide the surgical approach.
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Affiliation(s)
- B Puppala
- Neonatal Intensive Care Unit, Lutheran General Hospital, Park Ridge, IL 60068
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18
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Morris WM, Losken HW, le Roux PA. Spheno-maxillary meningo-encephalocele. A case report. J Craniomaxillofac Surg 1989; 17:359-62. [PMID: 2687333 DOI: 10.1016/s1010-5182(89)80106-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A patient is presented who was born with a large swelling on the left side of his face. This was removed by a paediatric surgeon at six weeks of age, and the histology was that of an encephalocele. Based on our findings at a later procedure to correct the child's facial asymmetry resulting from the congenital deformity, we concluded that this was a spheno-maxillary meningo-encephalocele. We have been able to find only one other such meningo-encephalocele reported in the literature.
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Affiliation(s)
- W M Morris
- Craniofacial Unit, Grey's Hospital, Pietermaritzburg, South Africa
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19
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Holbach LM, Naumann GO, Font RL. Neuroglial choristoma presenting as congenital lid tumor. Graefes Arch Clin Exp Ophthalmol 1989; 227:584-8. [PMID: 2696672 DOI: 10.1007/bf02169457] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A 12-month-old boy presented with a diffuse solid tumor of the nasal portions of the lower lid, which had caused almost complete narrowing of the interpalpebral fissure since birth. Clinically, it was suspected to be a mesenchymal tumor. Radiological studies revealed no bony defects in the orbit. The computerized tomographic (CT) scan disclosed a porencephalic cyst in the ipsilateral cerebral hemisphere. Excisional biopsy of the lid tumor revealed ectopic neuroglial tissue. The immunocytochemical demonstration of glial fibrillary acidic protein (GFAP) was consistent with the electron microscopic findings that disclosed fibrillary astrocytes with an abundance of typical 9- to 10-nm glial filaments. Heterotopic neuroglial tissue should be part of the differential diagnosis of congenital lid tumors; its occurrence may be associated with other anomalies of cerebral organogenesis.
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Affiliation(s)
- L M Holbach
- Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg, Federal Republic of Germany
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20
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Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 39-1989. A 63-year-old woman with a polypoid nasal mass and a recent grand-mal seizure. N Engl J Med 1989; 321:884-93. [PMID: 2770824 DOI: 10.1056/nejm198909283211308] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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21
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Smith YR, Valdes ME. Ectopic glial tissue in the forehead. A case report. SCANDINAVIAN JOURNAL OF PLASTIC AND RECONSTRUCTIVE SURGERY AND HAND SURGERY 1989; 23:77-9. [PMID: 2740853 DOI: 10.3109/02844318909067515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
A mass containing glial tissue was excised from the forehead of a 17-year-old female. The possible etiology of this tumor is reviewed.
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Affiliation(s)
- Y R Smith
- Plastic and Reconstructive Surgery Research Laboratory, Temple University Hospital, Philadelphia, Pennsylvania 19140
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22
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Yeoh GP, Bale PM, de Silva M. Nasal cerebral heterotopia: the so-called nasal glioma or sequestered encephalocele and its variants. PEDIATRIC PATHOLOGY 1989; 9:531-49. [PMID: 2813200 DOI: 10.3109/15513818909026912] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Twenty two nasal cerebral heterotopias were compared with 11 nasal encephaloceles. No histological feature was found that would allow a communication with the brain to be confidently identified or excluded. Even laminated cerebral cortex with neurones and ependymal canals, suggestive of encephalocele, were found in heterotopias. Distinction required radiological and surgical evidence. However, CT scan could be misleading, in one infant suggesting a cribriform plate defect when none was found at craniotomy. Three children had multiple extracranial glial lesions, two with both heterotopia and encephalocele in the same patient. In a few older children it was extremely difficult to identify brain tissue because of marked replacement by fibrous tissue (up to 95%), leading to one misdiagnosis as fibroma, and considerable fibrosis occurred also in five of six recurrences and in a longstanding small encephalocele. In two heterotopias, cellularity in places approached that of low-grade neoplastic glioma. One nasopharyngeal heterotopia contained multiple mesenchymal tissues suggestive of teratoma. Two midline nasopharyngeal encephaloceles showed adjacent epithelium, possibly vestiges of Rathke's pouch.
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Affiliation(s)
- G P Yeoh
- Institute of Pathology, Royal Alexandra Hospital for Children, Sydney, Australia
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23
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Gónzalez García M, Avila CG, López Arranz JS, García JG. Heterotopic brain tissue in the oral cavity. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1988; 66:218-22. [PMID: 3174056 DOI: 10.1016/0030-4220(88)90096-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
A most rare phenomenon of heterotopic brain in the soft palate, containing elements of choroid plexus, is presented. The principal theories regarding the pathogenesis of this malformation are presented and discussed. Its most frequent sites, the treatment to be followed, and the nomenclature to be employed in this type of lesion are also analyzed.
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Affiliation(s)
- M Gónzalez García
- Department of Oral and Maxillofacial Medical and Surgical Pathology, University of Oviedo Medical Faculty, Spain
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24
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25
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Abstract
A man of 25 with von Recklinghausen's neurofibromatosis (VR) developed nasal polyps. Subarachnoid haemorrhage occurred shortly after surgical excision and he died 9 weeks later. Post-mortem examination showed chronic hydrocephalus due to aqueduct stenosis. Histologically the polyps were a nasal glioma, a forme fruste of anterior encephalocoele not previously associated with VR, though other cranial defects are well recognized. Nasal glioma should be considered in the differential diagnosis of nasal lesions in VR.
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26
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Abstract
The term "nasal glioma" is a confusing misnomer as it implies a neoplastic condition with malignant potential, which it is not. Nasal glioma is a rare development abnormality and should be differentiated from glioma, which is a malignant tumor of the brain, and from a primary encephalocele, which is herniation of the cranial contents through a bone defect in the skull, through which it retains an intact connection with the central nervous system. Two cases of nasal glioma, one with and one without intracranial connections, are described and the literature is reviewed.
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27
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Abstract
We report a case of ectopic brain tissue in the orbit associated with a bony defect of the orbit and the presence of skeletal muscle. Previous reports of orbital ectopic brain and related lesions in the orbit and at other sites are reviewed.
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28
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Patterson K, Kapur S, Chandra RS. "Nasal gliomas" and related brain heterotopias: a pathologist's perspective. PEDIATRIC PATHOLOGY 1986; 5:353-62. [PMID: 3786265 DOI: 10.3109/15513818609068861] [Citation(s) in RCA: 89] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Brain heterotopias are rare congenital malformations embryologically related to encephaloceles. They present as a mass in or about the nose (nasal glioma) or in the nasopharynx. We present the clinical and pathological features of 5 cases of heterotopic brain tissue. Four nasal gliomas consisted of mature neuroglial tissue, including neurons in 2 cases, embedded in a fibrovascular stroma. A nasopharyngeal brain heterotopia showed histologic features of mature neuroglial tissue including neurons and ependymal-lined cystic structures. The finding of mature neuroglial tissue in a mass from the head and neck region raises three differential diagnostic possibilities: teratoma, encephalocele, or heterotopic tissue. A teratoma can be ruled out by examination of the entire specimen. Encephaloceles and brain heterotopias can be distinguished only after correlation with the patient's clinical and radiologic findings.
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29
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Abstract
Nasal gliomata are rare and experience in management is therefore not widespread. Clinical details of 5 children with nasal gliomata are presented. In each case the glioma was excised by an external approach without the need for craniotomy. These cases demonstrate the variability of presenting features and problems in management. They illustrate a relatively conservative surgical approach to treatment which we consider to be safe and effective. The characteristics of these unusual neural malformations are reviewed, and the management is discussed.
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30
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31
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Extra-nasal glioma. Indian J Otolaryngol Head Neck Surg 1984. [DOI: 10.1007/bf02994144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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32
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Primary Intranasal Encephalocele. J Neurosurg 1983. [DOI: 10.3171/jns.1983.59.6.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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33
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Heffner DK. Problems in pediatric otorhinolaryngic pathology, III. Teratoid and neural tumors of the nose, sinonasal tract, and nasopharynx. Int J Pediatr Otorhinolaryngol 1983; 6:1-21. [PMID: 6668102 DOI: 10.1016/s0165-5876(83)80100-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The terminology, classification, and histopathologic features of teratoid and neural masses of the nasal area of children can be confusing. Definitions, clinical features, and histopathologic differential diagnoses are discussed.
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34
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Abstract
Four cases of primary intranasal encephalocele are presented. Three of the patients had been treated for nasal polyps. One of these three patients presented with persistent cerebrospinal fluid (CSF) rhinorrhea after fourth a polypectomy, another with recurrent CSF rhinorrhea and bacterial meningitis following a second polypectomy, and the third case with recurrence of meningitis, also following polypectomy. Recurrent bacterial meningitis was the mode of presentation in the fourth case. Encephalocele was the isolated abnormality in three, but the fourth had a degree of associated hypertelorism. The diagnosis of encephalocele should be considered in any patient with a nasal polyp, especially in children and in patients with recurrent bacterial meningitis, with or without rhinorrhea, in the absence of cranial trauma or surgery, or in the absence of external craniospinal anatomical defects.
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35
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Abstract
Heterotopic brain is a developmental anomaly in which isolated brain tissue is found outside the cranial cavity. A case of this rare anomaly, simulating a neonatal palatine tonsil, is presented.
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36
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Abstract
Light and electron microscopic studies in a case of nasal glioma revealed a tumor composed nearly entirely of astrocytes. No ganglion cells or neurons were present and the mass was not surrounded by a capsule reminiscent for meningeal tissue. The vasculature resembled dermal patterns rather than typical central nervous system. No bone defect or connection to endocerebral tissue could be detected in the present case. Nasal glioma represents an ectopic focus of astrocytes, comparable to a hamartoma, rather than a true tumor or a herniation of brain tissue.
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Müller H, Slootweg PJ, Troost J. An encephalocele of the sphenomaxillary type. Case report. JOURNAL OF MAXILLOFACIAL SURGERY 1981; 9:180-4. [PMID: 6944419 DOI: 10.1016/s0301-0503(81)80040-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Vaquero J, Cabezudo JM, Salazar AR, Brasa J. Symptomatic intrasphenoidal meningoencephalocele after removal of a parasagittal meningioma. Acta Neurochir (Wien) 1981; 57:61-5. [PMID: 7270274 DOI: 10.1007/bf01665114] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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39
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Vaquero J, Cabezudo JM, Leunda G, Carrillo R, Bravo G. Intraorbital and intracranial glial hamartoma: case report. J Neurosurg 1980; 53:117-20. [PMID: 7411199 DOI: 10.3171/jns.1980.53.1.0117] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
A case is reported of a glial hamartoma located in the orbital fossa, with an extradural extension to the middle fossa. This location of a glial hamartoma has not previously been reported.
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Sharan R, Akhtar MP. Extra-nasal glioma. Indian J Otolaryngol Head Neck Surg 1979. [DOI: 10.1007/bf02992248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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41
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Okeda R. Heterotopic brain tissue in the submandibular region and lung. Report of two cases and comments about pathogenesis. Acta Neuropathol 1978; 43:217-20. [PMID: 696239 DOI: 10.1007/bf00691581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Two cases of extracranial heterotopia of the brain are reported. Case 1, in an otherwise normal female baby, had a brain heterotopia in the submandibular region. Case 2, in a still-born female baby with anencephaly, had the heterotopia in the lung. The lesion in case 1 is believed to be an encephalocele that has been pinched off through a cleft in the bone or through a foramen of the skull; the pathogenesis is similar to that of the so-called "nasal glioma". Concerning the pathogenesis of case 2, contrary to the generally supported embolism theory, observation of serial sections of the tumor in the lung favors the aspiration theory according to which amniotic brain tissue fragments, which are dislocated into the amnion because of nonclosure of the ventricle or following destruction of the fetal brain, are aspirated by fetal respiratory movements in the 4th to 6th month of intra-uterine life.
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Abstract
Six cases of nasal gliomas, which are rare ectopic rests of neural tissue found at the root of the nose, are presented. It is important to distinguish nasal tumors from basofrontal encephaloceles to avoid inadvertent exposure of the brain during the surgical removal of mass lesions. Because of their related embryologic origins, the distinction between nasal gliomas and basofrontal encephaloceles may not be clear clinically. Nasal gliomas may be treated by several surgical specialties, and only a proper awareness of their relatonship to encephaloceles can assure the selection of a flexible and adequate surgical approach. This paper emphasizes the salient clinical characteristics of nasal gliomas, their clinical distinction form and embryologic relationship to encephaloceles, and the options for treatment.
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Genut AA, Miranda FG, Garcia JH. Organized cerebral heterotopia in the ethmoid sinus. A case report. J Neurol Sci 1976; 28:339-44. [PMID: 932781 DOI: 10.1016/0022-510x(76)90027-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
A 60-year-old woman afflicted with spontaneous CSF rhinorrhea was found to have a heterotopia consisting of well-differentiated neurons organized in layers in the lamina propria of the mucosa of the ethmoid sinus. This heterotopic cerebral anlage is best classified within the spectrum of "nasal gliomas". The origin of this malformation is a failure of closure of the anterior neuropore which delays the ingrowth of the mesoderm that is destined to form the skull and dura beyond the 10th week of gestation, leaving behind trapped cerebral tissue. The presentation of this congenital malformation late in life is attributed to the development of sinusitis.
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Abstract
A case is presented of a jugular foramen syndrome caused by an ectopic glioma. Treatment was by intracapsular removal through a suboccipital craniectomy.
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Reddy CR, Rao TV, Murthy SS, Sundareshwar B. Gliomas of the nose and nasopharynx. Indian J Pediatr 1976; 43:37-41. [PMID: 939589 DOI: 10.1007/bf02901481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Gessaga EC, Anzil AP. Rod-shaped filamentous inclusions and other ultrastructural features in a cerebellar astrocytoma. Acta Neuropathol 1975; 33:119-27. [PMID: 173127 DOI: 10.1007/bf00687538] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A biopsy specimen of a cerebellar astrocytoma from a 14-year-old girl was studied by light and electron microscopy. Histologically the tumor showed a mixture of loose and compact areas with numerous Rosenthal fibers. By electron microscopy most tumor cells contained, besides the usual organelles, large amounts of 70 to 100 A thick filaments. Classical Rosenthal fibers were also identified. In addition many cell bodies and processes were sprinkled with fragments of Rosenthal fiber material. Ordered filamentous arrays (so-called Hirano bodies) were seen in a number of tumor astrocytes. They are considered to be a nonspecific arrangement of filament units largely devoid of cytopathologic significance. Other ultrastructural features of some tumor cells were inchoate forms of the granulated bodies of conventional histology, paired cisternal elements of rough endoplasmic reticulum, and honeycomb-like profiles of transversely cut cylindrical units of smooth endoplasmic reticulum. Microtubular bodies were numerous in the endothelial cells of the tumor vessels.
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Abstract
A case of nasal glioma is presented along with a brief review of the artiology, structure and diagnostic possibilities and published in earlier surveys. Considering the extremely benign nature of this type of tumour, we are of the opinion that the surgical measures may be relatively conservative and that mutilating, or grossly disfiguring, procedures should be avoided.
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Shuangshoti S, Netsky MG, Fitz-Hugh GS. Parapharyngeal meningioma with special reference to cell of origin. Ann Otol Rhinol Laryngol 1971; 80:464-73. [PMID: 5578792 DOI: 10.1177/000348947108000327] [Citation(s) in RCA: 39] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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