A Rare Case of Neuroglial Heterotopia of Nasopharynx

Document Type : Case Report

Authors

1 Department of ENT, SDM College of Medical Sciences, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka - 580009, India.

2 Department of Radiodiagnosis, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka-580009, India.

10.22038/ijorl.2025.88070.3960

Abstract

Introduction:
Neuroglial heterotopia (NGH), is a displaced mass of mature central neuroepithelial tissue unconnected to the brain proper.  NGH presents mostly with respiratory distress, neck mass and feeding difficulties at early age.
Case Report:
In our case, the nasopharyngeal NGH, a nine years old female child presented with otalgia and reduced hearing of left ear. Otological examination showed secretory otitis media.  On nasal endoscopy solitary, smooth, mucosa covered mass on the eustachian tube opening of left side blocking eustachian tube orifice. Imaging showed a well-defined, non-enhancing, isodense soft tissue lesion arising from left lateral wall of nasopharynx with complete opacification of middle ear and mastoid. Patient underwent left myringotomy and grommet insertion. Nasopharyngeal mass removed trans-nasally under endoscopic guidance. Histopathological examination of the mass showed features of Neuroglial heterotopia. Patient improved symptomatically.
Conclusion:
Possibility of NGH should be considered while evaluating children with congenital nasopharyngeal mass. Thorough clinical evaluation, radiological imaging to rule out intracranial connection and complete excision are necessary for successful management of such cases.

Keywords

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  1. Gmde M, Gdonh G, Radese S, Sguillar DA. Extensive parapharyngeal and skull base neuroglial ectopia; a challenge for differential diagnosis and treatment: case report. Sao Paulo Med J. 2010; 128: 302–5.
  2. Krishna LG, Uppoor R, Rao KN, Harish K. Heterotopic central Nervous tissue - nasal glioma: A case report. Indian J Radiol Imaging. 2005;15:511–6.
  3. 3 Giannas JE, Bayat A, Davenport PJ. Heterotopic nasopharyngeal brain tissue      associated with cleft palate. Br J Plast Surg. 2005; 58(6):862–4.
  4. Uemura T, Yoshikawa A, Onizuka T, Hayashi T. Heterotopic nasopharyngeal brain tissue associated with cleft palate. Cleft Palate Craniofac J. 1999; 36(3):248–51
  5. Cohen AH, Abt AB. An unusual cause of neonatal respiratory obstruction: heterotopic pharyngeal brain tissue. J Pediatr. 1970;76(1):119–22.
  6. Bossen EH, Hudson WR. Oligodendroglioma arising in heterotopic brain tissue of the soft palate and nasopharynx. Am J Surg Pathol. 1987; 11(7): 571–4.
  7. Gold AH, Sharer LR, Walden RH. Central nervous system heterotopia in association with cleft palate. Plast Reconstr Surg. 1980;66(3):434-41.
  8. Lee SC, Henry MM, Gonzalez-Crussi F. Simultaneous occurrence of melanotic neuroectodermal tumor and brain heterotopia in the oropharynx. Cancer. 1976;38(1):249–53.
  9. Chan JK, Lau WH. Nasal astrocytoma or nasal glial heterotopia? Arch Pathol Lab Med. 1989; 113(8):943–5.
  10. Karunakaran P, Duraikannu C, Pulupula VNK. An unusual presentation of neuroglial heterotopia: case report. BJR Case Rep 2020; 5: 20190116
  11. Baquero-Hoyos, M.M, Marino, J.A, Mayorga, J.L. Nasopharyngeal neuroglial heterotopy - Choristoma: Case report and review of the literature. World Journal of Otorhinolaryngology - Head and Neck Surgery, 7: 318-321
  12. Stucki B, Marcincuk MC. Two Presentations of Neuroglial Heterotopias with Cleft Palate. Cureus. 2025 Aug 11;17(8):e89834. Doi: 10.7759/ cureus. 89834. PMID: 40937232; PMCID: PMC12422761.
  13. Gökler O, Karanfil I, Koçak İ, Altuntaş MO, Armutlu A, Ünal ÖF. Nasopharyngeal Glial Heterotopia with Intracranial Extension: A Case Report. Turk Arch Otorhinolaryngol. 2018 Sep; 56(3): 177-179.