An unusual lateral nasal wall mass: Heterotopic glial tissue

Objective: To describe clinical, radiologic, and histological features of a heterotopic glial tissue presented as a rare cause of lateral nasal wall mass in a child. Study Design: Case review Methods: Chart of a 13-month-old male referred to a tertiary care pediatric hospital for assessment of nasal mass was reviewed. Data included relevant history and physical examination, diagnostic work up, and management. Results: The child has been having a nasal mass located on the right lateral nasal wall since the early days of life. Parents noticed that the mass has been slowly increasing in size as the mass started to cause external deformity of the nose. The child had no difficulty breathing through nose, no epistaxis, no recurrent sinus infection, and no snoring. Physical examination revealed a mass located on the right lateral nasal wall causing displacement of the nose to the left. CT imaging documented nonlipomatous soft tissue mass involving the right nasal soft tissues and protruding into the anterior right nasal cavity. The foramen cecum appeared mildly enlarged. MRI of the lesion documented a lobulated mass located in the region of nasal process of the right maxillary bone. There was no apparent intracranial extension. Upon resection of the mass using lateral rhinotomy approach, histologic evaluation showed glial tissue intermixed with fibrous bands. Immunohistochemical staining documented positive glial fibrillary acid protein confirming heterotopic glial tissue. At 7 month follow-up, the surgical site was healed with no evidence of recurrent lesion. Conclusions: Heterotopic glial tissue, although uncommon, should be considered in the differential diagnosis of lateral nasal wall mass in children.