Serviço de Neurorradiologia, CHULC
Neuroradiology Department, Hospital Dona Estefânia e Hospital São José, Centro Hospitalar Universitário de Lisboa Central – CHULC
- XV Congresso Nacional da SPNR, 28-29 Junho 2019, Coimbra
- Neuroradiology (2020) 62:109–127. https://doi.org/10.1007/s00234-019-02317-7
Purpose: Nasal gliomas are rare and benign congenital lesions of the craniofacial region composed of heterotopic masses of neuroglial tissue, for this reason, the term nasal glioma is not accurate, nasal brain heterotopia or nasally trapped brain might be a better term. They may manifest extranasally (60%), intranasally (30%), or both (10%). The diagnosis is made by histopathological observation, backed up by previous characterization on CT and MR imaging, although one should always consider other differential diagnosis on congenital nasal masses such as encephaloceles and nasal dermoids.
Materials and Methods: We used CT and MR images of our department’s Neuroradiology database to illustrate a rare case of a Nasal Glioma. Some features and clues to the differential diagnosis on MR and CT are discussed.
Results: We present a case of a 4-month-old infant who was regularly followed in ENT consultation due to left nasal obstruction and sleep apnea caused by an intranasal congenital mass. CT scan showed an expansile left intranasal mass that deviated the septum obstructing the normal air flow. MRI study confirmed that this lesion was non-enhancing with heterogeneous T2 signal (iso and hyper) and extending from the left nasal fossa reaching the foramen cecum, without intracranial extension, being the most favorable hypothesis a nasal glioma.
Conclusion: Nasal gliomas and other anterior craniofacial congenital masses are uncommon lesions. Nevertheless, we should familiarize with the most frequent expansile masses from this region, as they are solely managed surgically, with early operative intervention believed to correlate with more favorable aesthetic outcomes. Imaging evaluation to this day plays a crucial role in the work-up of this condition.
Palavras Chave: nasal glioma; nasal brain heterotopia; neonatal nasal obstruction; MRI