Nasales Gliom als seltene Ursache der behinderten Nasenatmung beim Neugeborenen

Abstract

Congenital midline nasal masses are rare entities occurring once in 20-40,000 births. They are often misdiagnosed or even missed. These tumors are most commonly present in newborn infants and children, but rarely they can be discovered in adults as well. The differential diagnostic possibilities are dermoids, gliomas, encephaloceles and epidermoid cysts. Although they are benign, they have the potential for disfigurement, destruction and causing a meningitis, therefore they require prompt diagnosis and management. Because of a possible connection to intracranial structures a complete radiologic evaluation is essential. The treatment for these nasal masses is surgical resection, endoscopically controlled procedures are preferred. We report the case of a newborn with respiratory distress shortly after birth. The infant was discharged from the hospital, because the unexplained symptoms were not progressive. After a few days the child was send to an otolaryngologist, who found a suspicious mass near the top of the nose and performed a biopsy. At 20 days of age the infant was brought to our children's hospital for additional diagnostic procedures and therapy. The MRI showed a soft tissue mass (1.2 x 0.7 x 1.1 cm) in the nasal cavity. There was no clear-cut evidence of an intracranial extension, for further evaluation a radionuclide scan was performed. This confirmed the integrity of the base of the skull. 6 weeks after the birth a smooth tumor was successfully removed by an endoscopically controlled operation. Histopathologic studies confirmed neuroglial tissue. Because of ist rare incidence, many physicians are not familiar with the diagnosis and management of these tumors. Respiratory abnormalities in newborn should always lead to a careful physical examination and complete radiologic evaluation, i.e. MRI, CT and radionuclide scan.