Both nasal cerebral heterotopia and encephalocele in the same patient.
OBJECTIVE AND PATIENT: Both nasal cerebral heterotopia and encephalocele are rare congenital benign masses of neurogenic origin caused by an embryonic developmental abnormality. It is generally accepted that nasal heterotopia is a sequelae to encephalocele. This report presents an unusual case of nasal cerebral heterotopia and encephalocele arising in the same patient. The patient had a firm, solid mass measuring 1.5 x 1.0 cm on the bridge of the nose covered with normal skin and another mass in the nasal cavity obstructing the right nasal cavity. Computed tomography (CT) demonstrated that the nasal bone separated these masses. CT also showed a bony defect at the skull base. Surgery consisted of dividing the encephalocele and closure of the skull base fistulae, along with nasal subcutaneous mass enucleation.


RESULTS
Intraoperative examination indicated the existence of a pit on the nasal bone where the pedicle of the nasal subcutaneous mass connected. Microscopic examination of the nasal cavity mass demonstrated meningoencephalocele, and examination of the nasal subcutaneous mass demonstrated nasal cerebral heterotopia, which was confirmed by immunohistochemical staining. After 10 months, complete removal of the subcutaneous nasal mass was recognized and there was no evidence of recurrence.


CONCLUSIONS
Findings in this case suggest that the nasal cerebral heterotopias will result from encephalocele.
Fujioka
Masaki
M
Department of Plastic and Reconstructive Surgery, National Nagasaki Medical Center, Nagasaki, Japan. mfujioka@nmc.hosp.go.jp
Tasaki
Isao
I
Nakayama
Riko
R
Yakabe
Aya
A
Baba
Hiroshi
H
Toda
Keisuke
K
Itoh
Masahiro
M
Hirano
Akiyoshi
A
D001921:Brain; D002828:Choristoma / Q000150:complications* / Q000473:pathology; D004677:Encephalocele / Q000150:complications* / Q000473:pathology; D005904:Glial Fibrillary Acidic Protein / Q000032:analysis; D006801:Humans; D007223:Infant; D007633:Keratins / Q000032:analysis; D008297:Male; D008578:Meninges / Q000473:pathology; D008588:Meningocele / Q000150:complications* / Q000473:pathology; D009295:Nasal Bone / Q000473:pathology; D009296:Nasal Cavity / Q000473:pathology*; D015508:Nasal Obstruction / Q000209:etiology; D009457:Neuroglia / Q000473:pathology; D009668:Nose Diseases / Q000150:complications* / Q000473:pathology; D009836:Oligodendroglia / Q000473:pathology; D009418:S100 Proteins / Q000032:analysis; D019291:Skull Base / Q000002:abnormalities
D005904:Glial Fibrillary Acidic Protein; D009418:S100 Proteins; D007633:Keratins