[A cause of neonatal respiratory distress: cerebral tissue heterotopia in the cavum].
BACKGROUND
Brain heterotopia can be reflected in disturbances of the oropharynx during the neonatal period, such as acute upper airway obstruction. The main differential diagnosis is encephalocele, which must be recognized before undertaking any surgical procedure.


METHODS
A boy, aged 5 days, with a cleft palate and bifid uvula, was admitted for respiratory distress. The distress initially occurred during bottle-feeding, but later became permanent. A solid mass, seemingly implanted in the superior wall of the pharynx, was successfully removed by forceps. A later CT scan showed the absence of any defect in the cribriform plate, thus excluding diagnosis of encephalocele. Histological, examination of the mass showed glial tissue without neurons.


CONCLUSIONS
The presence of a pharyngeal mass in a newborn signals three possibilities: teratoma, heterotopic brain tissue or encephalocele. Encephalocele must by ruled out by a preoperative CT scan with a water soluble contrast agent in order to avoid CSF leakage and meningitis. Respiratory distress should be treated by oral endotracheal intubation to allow time for CT scan investigation.
Josset
P
P
Laboratoire Central d'Anatomie et Cytologie pathologiques, Hôpital Trousseau, Paris.
Boccon-Gibod
L
L
Lacombe
H
H
D001921:Brain / Q000196:embryology; D002828:Choristoma / Q000150:complications* / Q000175:diagnosis / Q000196:embryology; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009303:Nasopharyngeal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000196:embryology; D012127:Respiratory Distress Syndrome, Newborn / Q000209:etiology*; D014057:Tomography, X-Ray Computed
Une cause de détresse respiratoire néonatale: hétérotopie de tissu cérébral dans le cavum.