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Review
. 2009 Aug;29(4):218-21.

Central nervous system tissue heterotopia of the nose: case report and review of the literature

G Altissimi  1 , S Ascani, S Falcetti, C Cazzato, I Bravi
Affiliations
Review

Central nervous system tissue heterotopia of the nose: case report and review of the literature

G Altissimi et al. Acta Otorhinolaryngol Ital. 2009 Aug.

Abstract
in English, Italian

The authors present a case of heterotopic central nervous system tissue observed in an 81-year-old male in the form of an ethmoidal polyp. A review of the literature indicates that this is a rare condition characterised by a connective tissue lesion with astrocytic and oligodendrocytic glial cells, which may be located outside the nasal pyramid in some cases and inside the nasal cavity in others. The most important diagnostic aspect involves differentiating these from meningoencephalocele, which maintains an anatomical connection with central nervous system tissue. Contrast-enhanced imaging is essential for diagnosis, as in cases of heterotopic central nervous system tissue, it will demonstrate that there are no connections with intra-cranial tissue. Endoscopic excision is the treatment of choice.

Gli Autori presentano un caso di eterotopia di tessuto nervoso centrale osservato in un uomo di 81 anni sotto forma di polipo etmoidale. Da una revisione della letteratura risulta trattarsi di una patologia rara, caratterizzata da una neoformazione di tessuto connettivo in seno al quale sono reperibili cellule gliali di tipo astrocitario ed oligodendrocitico, a volte localizzata all’esterno della piramide nasale, a volte all’interno delle fosse nasali. L’aspetto diagnostico più importante risiede nella sua differenziazione dai meningoencefaloceli, che mantengono un collegamento anatomico con il tessuto nervoso centrale. Dirimente in tal senso è la diagnostica per immagini con mezzo di contrasto, che in caso di eterotopia di tessuto nervoso centrale dimostrerà l’assenza di connessioni con i tessuti endocranici. L’asportazione con tecnica endoscopica è oggi la terapia di scelta.

Keywords: Central nervous system tissue heterotopia; Encephalocele; Nasal cavity.

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Figures

Fig. 1
Fig. 1
Macroscopic appearance of intranasal lesion.
Fig. 2
Fig. 2
CT shows unilateral growth that occupies right nasal-paranasal sinuses.
Fig. 3
Fig. 3
Histological examination: fibrous tissue with a considerable number of small vessels, astrocytes, oligodendrocytes and occasional neurons. (H&E, 250x.).
Fig. 4
Fig. 4
Intense staining of glial elements in response to glial fibrillary acid protein (GFAP). (Immunoperoxidase-antiperoxidase staining, 50x.).
Fig. 5
Fig. 5
Expression of S100 protein in glial heterotopic tissue. (Immunoperoxidase-antiperoxidase staining, 50x.).
See this image and copyright information in PMC

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