A Rare Case of Nasal Glial Heterotopia in an Infant

Abstract

Glial heterotopias are the displacement of neuroglial tissue in extracranial sites. Nasal glial heterotopias can be of three types-extranasal, intranasal and mixed. Root of the nose is the most common location. These are rare anomalies with an incidence of 1 case in 20,000-40,000 live births. Here we report the case of a 6-month-old infant with a congenital mass located at the root of the nose. Non-contrast computed tomography studies showed no evidence of intracranial communication of the lesion. The mass was excised, and on histopathological examination, it showed glial tissue with astrocytes in a fibrillary background and fibroconnective tissue. Masson's trichrome stain showed the red staining of the glial tissue, whereas the background fibrosis was stained blue. On immunohistochemistry, glial fibrillary acidic protein was positive. Hence, the diagnosis of nasal glial heterotropia was made. The patient had an uneventful postoperative period.

Keywords: Nasal glial heterotopia; infant; nasal glioma.

Figure 1

(A) Preoperative photograph of the child with swelling at the root of nose. (B) Postoperative photograph of the child

Figure 2

NCCT showing no connection between the mass and the dura or brain

Figure 3

(A) Cut section of the mass showing homogenous gray-white solid soft tissue lesion. No hemorrhage or necrosis is seen. (B) Glial tissue with intervening fibrosis (hematoxylin and eosin [H and E], ×100). (C) Astrocytes in a fibrillary background (H and E, ×100). Few gemistocytes seen (arrow)

Figure 4

(A) The glial tissue is immunopositive for GFAP (immunohistochemistry, ×100). (B) The glial tissue stained dusky pink to red in color on Masson’s trichrome stain (×100), whereas the fibrous tissue stained blue