Cystic and solid heterotopic brain in the face and neck: A review and report of an unusual case

doi:10.1016/S0022-3468(05)80015-6

Journal of Pediatric Surgery

Volume 25, Issue 7, July 1990, Pages 766-768

https://doi.org/10.1016/S0022-3468(05)80015-6 Get rights and content

An unusual case of heterotopic brain tissue was confused as a lymphangioma in the neck. Although these lesions are rare, they should be included in the differential diagnosis of congenital head and neck masses. They can compress and deform surrounding structures and cause airway obstruction in the newborn. Excision is curative, but the possibility of encephalocele should be eliminated by prior computed tomography scan.

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Cited by (26)

Heterotopic Neuroglial Tissue in Sphenoid Ridge
2019, World Neurosurgery
Citation Excerpt :
Even malignant degeneration is possible, as a case of an oligodendroglioma shows.15 The growth pattern of those lesions is assumed to be similar to that of other neuroglial tissue,16,17 except from cystic lesions containing functional choroid plexus, which may show extensive gain of volume.17 Symptomatic lesions in the adult are rare and may be the result of a secondary spread of tissue.
Extracerebral neuroglial heterotopias are rare manifestations of cerebral tissue outside the brain whose most common form is the so-called nasal glioma. In this case report we illustrate the first case of heterotopic neuroglial tissue within the bone of the skull.
Our patient underwent surgery for a sphenoid ridge meningioma. Aside from the expected meningioma, histopathologic examination showed a small amount of intraosseous heterotopic neuroglial tissue.
The pathogenesis of cerebral heterotopias is diverse. Most of the midline lesions are probably residuals of former meningoencephaloceles. The pathogenesis of extracranial nonmidline lesions is more questionable. Their cause might be a former trauma, inflammatory disease, or surgery. Another option is that they represent primary neuroglial heterotopias, as it is supposed for manifestations of the lung.
The coexistence of a heterotopia and a meningioma in this case is probably a coincidence. It is also debatable whether the broad tumor extension within the bone and/or the heterotopia might go back to alterations of the bone structure.
Case series of congenital heterotopic neuroglial tissue in the parapharyngeal space
2016, International Journal of Pediatric Otorhinolaryngology
Citation Excerpt :
There have only been 200 cases of heterotopic glioneuronal tissue reported and most are within the nasal cavity [2]. Other locations of the head and neck such as the orbit, middle ear, tongue, palate, pharynx, scalp or parapharyngeal space have also been described [1–10]. Here we present two cases of glioneuronal heterotopia arising 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.
Parapharyngeal neuroglial heterotopia: An unusual entity
2014, International Journal of Pediatric Otorhinolaryngology Extra
Neuroglial heterotopia is a rare condition in which mature neuroglial tissue is found in the body other than in the central nervous system (CNS). We report a rare case of heterotopic neuroglial tissue in the left parapharyngeal space. Ultrasound neck was suggestive of atypical cystic hygroma. Computerized Tomography (CT) and Magnetic resonance imaging (MRI) revealed a heterogeneous mass with cystic component occupying the parapharyngeal space. No connection to intracranial structures was noted. Histological findings were compatible with neuroglial heterotopia.
Image-guided transoral resection of recurrent parapharyngeal space glial heterotopia
2014, International Journal of Pediatric Otorhinolaryngology
Intranasal glial heterotopia is an uncommon congenital nasal lesion of neuroectoderm origin. Involvement of the parapharyngeal space is extremely rare. We present a case report of a newborn with life-threatening respiratory distress and feeding difficulty caused by a nasal glial heterotopia in a rare location involving the nasopharynx and parapharyngeal space. Surgical treatment was done in a staged fashion, involving image guidance for recurrence. Other diagnostic and treatment options are reviewed in the light of current literature.
Parapharyngeal neuroglial heterotopia in Pierre Robin sequence: MR imaging findings
2009, International Journal of Pediatric Otorhinolaryngology
Citation Excerpt :
Parapharyngeal heterotopia of neuroglial tissue is a rare entity, already described by few authors [1–3], the most frequent location being the nasal cavities [4,5], where it is traditionally but erroneously called “nasal glioma”.
Heterotopic neuroglial tissue is a rare lesion, occurring more frequently in the nasal cavities. Other rare locations are the orbit, the scalp, the palate, the pharynx, the parapharyngeal space and the lungs. They are usually detected occasionally because they are often asymptomatic, but sometimes they might present with dyspnoea, feeding difficulty, snorting and nasal flaring. Respiratory symptoms occur when heterotopic neuroglial tissue is located in the parapharyngeal space. We report a case of an infant affected by Pierre Robin sequence (PRS) who was admitted to our Institution for a worsening respiratory distress that was not explainable only by PRS.
Heterotopic brain in the parapharyngeal space
1996, International Journal of Pediatric Otorhinolaryngology
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.

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^*: Presented at the 22nd Annual Meeting of the Pacific Association of Pediatric Surgeons, Portland and Sun River, Oregon, May 22–26, 1989.

¹: From the Primary Children's Medical Center and the Department of Surgery, University of Utah Health Sciences Center, Salt Lake City, UT.

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Cystic and solid heterotopic brain in the face and neck: A review and report of an unusual case*

Ophthalmol

Congenital glioma on the left side of the face

Calif Med

Glioma of the face

Plast Reconstr Surg

Heterotopic brain presenting as a cystic neck mass with mandibular deformity

Pediatr Pathol

Uber angeborene Hirnbrucke in den Stirn und Nasengegend

Illustrierte Med Ztg

Ueber seltene Spaltbildungen im Bereiche des mittleren Stirnfortsatzes

Virchows Arch