Glioma nasal gigante: reporte de un caso

Abstract

Los gliomas nasales son restos de tejido neuroglial que se presentan como una masa craneofacial. Es poco frecuente y no tiene características malignas, pero localmente es bastante agresivo. Se encuentra dentro del diagnóstico diferencial de masas congénitas de la línea media. Se presenta el caso de un recién nacido que presenta un pólipo nasal derecho y distrés respiratorio. La RNM revela una masa intranasal sin conexión intracraneal. Vía endoscópica se realiza exéresis de la masa sin complicaciones. Biopsia confirma diagnóstico de glioma.

Intranasal Glioma with Post-Endoscopic Resection in 1 Year Old Infant: Case Report and Literature Review*

“…1,4,8,15,16 Bearing in mind that newborns are mandatory nasal breathers and that upper airway obstruction at delivery has been described among patients with nasal and nasopharyngeal gliomas, prenatal MRI imaging in the presence of suspicion is paramount for that the appropriate intervention is made at the time of birth. 7,11 Fig. 4 Sequence of MRI sections of the face showing persistence of the residual lesion in the left nasal cavity.…”

“…The latter are the ones with the most intracranial connection, which occurs in 35% of cases. 2,5,7,10,[15][16][17] Also called glial nasal heterotopy, due to the non-neoplastic nature of the lesion, gliomas are not considered hereditary. Some authors believe there is a predilection for the tumor in males, in a ratio of 3:2.…”

“…Therefore, in order for the excision to be the best possible, an adequate evaluation is essential to define the site, extent and content of the tumor. [1][2][3][7][8][9]15,16,18 Prenatal ultrasound can raise the diagnostic suspicion by revealing a solid frontonasal mass, with a final diastolic characteristic of low arterial flow velocity on Doppler. 3,6,10,14 MRI is considered the best exam for the analysis of nasal glioma, as it shows in detail the soft tissues and the possibility of intracranial connection, in addition to not using radiation.…”

“…In cases of extranasal gliomas, the masses appear between the tip of the nose and the eyebrow and there may be bone deformities, hypertelorism, visual or lacrimal changes and the growth of a mass somewhere on the face. 1,2,7,16 In 5% of cases, glioma can occupy other locations, such as scalp, cheek, soft palate, tonsil, medical ear, nasopharynx, oropharynx, submandibular region and orbit. 7,15 Surgical resection of the mass is the treatment of choice, since gliomas are not sensitive to radiation therapy.…”

“…13 Heterotopy has an approximate incidence of one case for every 20.000 to 40.000 live births and is considered benign but can cause deformities due to its slow growth. 3,7,9,11,14,15 Some authors report that there is no gender predominance, while others believe that the anomaly is more common in boys (3:2). There is no family predisposition.…”