A Neonatal Case of Glial Choristoma of the Tongue Causing Airway Obstruction

Abstract

Glial choristoma is considered to be a type of brain heterotopia consisting of ectopic central nervous tissue. We herein report a neonate with glial choristoma of the tongue who developed respiratory distress due to airway obstruction. A male neonate presented with respiratory distress due to a soft mass on the midline region of the dorsal tongue base at birth. He was intubated using a flexible fiberoptic nasopharyngoscope. MRI showed a well-circumscribed mass measuring 25 × 23 × 27 mm in size in the same region. A histologic examination confirmed a pathological diagnosis of glial choristoma. He underwent tracheotomy at 22 days of age, and a subtotal resection of the tumor was performed at five months of age. The clinical behavior of oral glial choristoma varies depending on the age at onset as well as the location and size of the mass. The small size of the organ and the narrow operating field hamper the surgical approach in neonates. The optimal therapeutic strategy for neonatal cases of glial choristoma should thus be determined based on the condition of each individual patient.

Glial heterotopia of the base of tongue: a case report

“…On the other hand, Birrell et al, suggested the possibility of a displaced neural tissue through a persistent communication between cranial end of foregut (Seessel's pouch) and the base of occiput portion of the foetal head. An alternative theory suggested formation of a sequestrated encephalocele following the formation of Ratkhe's pouch when a portion of craniopharyngeal canal persisted 9 . It is nevertheless being agreed upon that glial heterotopia represents a non-neoplastic developmental anomaly, even though cases of malignant transformation have been reported 1,2 .…”

Massive mature cystic teratoma of the head and neck, masquerading as a glial choristoma, causing respiratory compromise of a neonate

“…A glial choristoma is not neoplastic in nature as it grows alongside the surrounding tissue in an expansive manner without infiltrating it 6. These occur mainly in the head and neck region,4 and contain heterotopic neural tissue 1. Glial choristoma refers to ectopic central nervous tissue which is not continuous with the brain 5.…”

“…Glial choristomas are rare congenital malformations found primarily in neonates and young children. Approximately 250 cases affecting the nasal area and 33 cases affecting the oral cavity have been described in the literature 3 4. No previous cases have been described in the Eastern Cape, South Africa.…”

“…A choristoma is a congenital heterotopic mass of microscopically normal cells, occurring in an abnormal location 1. These occur mainly in the head and neck region,4 and may contain heterotopic gastric mucosa, neural tissue, cartilage, bone or epithelium 1. Glial choristoma refers to ectopic central nervous tissue, embryologically linked to an encephalocele, although it is not continuous with the brain 5.…”

“…Glial choristoma refers to ectopic central nervous tissue, embryologically linked to an encephalocele, although it is not continuous with the brain 5. According to the literature, the most commonly occurring glial choristoma is a nasal glioma, with the parapharyngeal space and oral cavity being extremely rarely involved 4 6. Within the oral cavity and parapharyngeal space, lesions most frequently affect the palatopharyngeal area, followed by the tongue, oropharynx, upper lip and submandibular area 4–7…”