Nasal glial heterotopia: a systematic review of the literature and case report

Abstract

SUMMARY Nasal glial heterotopia (NGH) is a rare congenital, non-neoplastic displacement of cerebral tissue in extracranial sites. Together with a case report of NGH, we present the first systematic review of all published cases in order to summarise the relevant clinical findings and appropriate therapy, making the available evidence accessible to decision makers. A total of 72 original publications including 152 NGH cases were identified. The male:female ratio was 3:2. Most patients were children under 18 years (130 patients) and only 8% of cases were diagnosed in adults. The main clinical presentation forms were asymptomatic masses around the nasal root as well as nasal congestion. Magnetic resonance imaging was performed in 39% of patients, computed tomography in 22% of patients and a combination of both in 20% of patients. A diagnostic biopsy was performed in only 7 patients. All patients underwent surgical treatment and recurrence was reported in 14 patients within the first year of follow-up. In conclusion, NGH should be considered as a differential diagnosis of nasal masses in children. MRI is mandatory in order to exclude a connection to the central nervous system. Complete resection is curative treatment.

Endemic Systemic Mycoses in Italy: A Systematic Review of Literature and a Practical Update

“…Nevertheless as all but one of the cases were diagnosed before 2013, one cannot disregard misidentifications with the recently described species B. gilchristii and B. helicus . Only four subjects have a travel history in these countries, respectively: Ghana [ 25 ], Senegal [ 34 ], Central America [ 35 ] and Canada [ 36 ]. Only two patients developed pneumonia [ 36 , 37 ], the other eight presented with extrapulmonary manifestations: bone, joints and soft tissues (n = 5) [ 25 , 34 , 36 , 38 ], oral cavity (n = 3) [ 35 , 39 ] and adrenal glands (n = 1) [ 40 ].…”

Retroperitoneal neuroglial heterotopia: a case report and literature review

“…Neuroglial heterotopia is a rare congenital developmental malformation first reported in the nasal cavity by Reid in 1852 ( 2 ). Over time, various terms have been introduced to describe this condition, including glial heterotopia, glial choristoma, heterotopic glial tissue, heterotopic neural tissue (HNT), ectopic brain, and ectopic neural tissue.…”

“…Paraneuraxial neuroglial heterotopia, characterized by a well-formed layer of brain tissue histologically, can occur in the paracranial region (occipital bone, deep cervical part) or paravertebral spaces (retroperitoneum) ( 8 – 10 , 13 ). In contrast, the extraneuraxial group primarily affects the superficial layer of the head and neck, including the cavum nasi, and is characterized by the disorganization of neuroglial and mesenchymal tissues ( 2 ). The etiopathogenesis of retroperitoneal neuroglial heterotopia remains unclear.…”

“…Immunohistochemical staining for GFAP, S100, and NSE corroborated the presence of glial tissue in the current case. Additional markers such as synaptophysin ( 2 , 5 , 6 , 10 , 12 , 14 ), NeuN ( 7 ), vimentin ( 5 , 9 , 14 ), chromogranin A (CGA) ( 2 ), CD56 ( 11 ), and neurofilament (NF) ( 5 – 7 ) contribute to confirming the diagnosis. It is imperative to further validate serum NSE or alternative biomarkers as diagnostic and prognostic tools for neuroglial heterotopia, necessitating a larger sample size to bolster their significance.…”

“…However, only one case underwent a diagnostic fine-needle aspiration (FNA) ( 12 ). Previous studies suggest that biopsies are not recommended for congenital midline lesions with potential intracranial connections due to the risk of cerebrospinal fluid leakage ( 2 ). Nevertheless, if an intracranial connection is excluded through MRI, a biopsy may be feasible, especially for ruling out malignancy.…”