Adult nasal glioma presenting with visual loss

Abstract

To our knowledge, this is the first report in the English language literature of adult nasal glioma presenting with visual loss. The management of nasal gliomas in adults is contentious and the relevant literature is reviewed. This case was managed conservatively with regular follow up.

Adult nasal gliomas

“…Diagnosis was usually made following an incidental finding of heterotrophic glial tissue after incisional biopsy of a nasal polyp. Other presentations were acute or recurrent meningitis, 13 , 16 meningoencephalitis, 21 and visual loss 17 , 18 …”

“…[13][14][15][16][17][18][19][20][21][22][23][24][25][26] Most patients were asymptomatic, or had symptoms of nasal obstruction or clear rhinorrhoea. Diagnosis was usually made following an incidental finding of heterotrophic glial tissue after incisional biopsy of a nasal polyp.…”

“…Other presentations were acute or recurrent meningitis, 13,16 meningoencephalitis, 21 and visual loss. 17,18 Histologically, nasal gliomas have no meningeal envelope, and are covered by skin or nasal respiratory mucosa. They are composed of vascularised, dense fibrous connective tissue, with mature astrocytic and oligodendrocytic glial cells, and sometimes contain neurons and ependymal cells.…”

A Case of Nasal Glial Heterotopia in an Adult

“…It is thought to be the result of abnormal embryonic development. Approximately 250 cases have been reported [6], but only a few adult cases are known [3, 7–10]. …”

“…This test is typically positive when encephalocele is involved [9]. CT is useful for the visualization of bony defects in the anterior skull base, whereas MRI provides complementary information regarding the fluid or soft tissue characteristics of the mass [7]. Commonly, MRI T2-weighted imaging can reveal hyperintensity related to gliosis and isointensity related to normal respiratory mucosa and indicates the absence of a CSF space or subarachnoid space connection with the lesion.…”