Diagnosis and treatment of the pharyngeal glial choristoma accompanied with incomplete cleft palate

Abstract

Introduction:A choristoma formed by heterotopic tissue rarely occurs in the throat, especially one accompanied with cleft palate in a new-born baby.Patient concerns:An 18-month-old female patient was admitted to the hospital for apparent snoring symptoms accompanied by mouth breathing and sleep apnea. In addition, the patient presented with weak aspiration and nasal leakage during fluid intake.Diagnosis:The patient received routine physical examination and endoscopy showing that there was a wide fissure which split from the palate vertical anterior cleft to 1/3 of the hard palate. Meanwhile, we found an unclear-bordered uplift in the left palate and a soft mass. The radiographs revealed a mass with inhomogeneous density convex to the pharyngeal cavity.Interventions:The patient was subsequently referred for surgical resection and tissue diagnosis of choristoma was confirmed by pathological examination. H&E staining showed well demarcated mature brain tissue with scattered sand-like calcification.Outcomes:According to the diagnosis, the patient suffered from pharyngeal glial choristoma and incomplete cleft palate. The surgical resection and repair were performed together. The postoperative recovery was very good.Lessons:Choristoma rarely occurs in the head and neck, especially if accompanied by cleft palate. Early diagnosis for choristoma relies heavily on clinical examination and radiological imaging. Complete resection of choristoma remains the gold standard for treatment of these patients.

A Rare Case of Glial Choristoma Arising from the Vomer in Association with Cleft Palate

“…Surgical intervention is necessary to guarantee adequate growth and functional development. 6 Neuroglial choristomas (NGC) are very rare malformations, also called heterotopic brain, defined as a mass-like lesion composed of mature brain tissue isolated from the cranial cavity or spinal cord. 2 Some authors have divided NGC into lesions that are paraneuroaxial and those remote from the neuroaxis.…”