The clinical presentation, imaging, treatment, and pathology of a case of neuroglial heterotopia in the nasopharynx causing airway obstruction in a newborn are reported from Columbus Children’s Hospital, OH. MRI and CT showed a cystic mass filling the nasopharynx with a midline bony defect in the sphenoid bone above the clivus. Posterior nasal endoscopy visualized the cystic lesion prior to surgical removal. Connection with CSF and subarachnoid space was excluded. At 6-month follow-up, developmental miletones were normal, and repeat CT showed no evidence of recurrence of the mass. Histopathology of the lesion showed choroid plexus, glial, and respiratory-like epithelial cells. [1]
COMMENT. Reviewing the literature, the authors found reports of 30 cases of pharyngeal neuroglial heterotopia. Both CT and MRI are recommended in the assessment of nasopharyngeal masses. CT visualizes any bony deformities of the skull base, and MRI detects intracranial connections through the skull defect. Encephalocele has a similar histology but differs from neuroglial heterotopia by maintaining a connection to the subarachnoid space.