A case of large oropharyngeal glial heterotopia causing airway obstruction in a newborn: A case report and brief review of literature.

introduction and importanceGlial heterotopia (GH) is a rare congenital lesion characterized by the presence of normal glial tissue in extracranial sites with no connection to the central nervous system. Oropharyngeal occurrence is very rare. The aim of this case report is to emphasize that oropharyngeal glial heterotopia can present as a large mass causing airway obstruction. PRESENTATION OF CASE: A 21-h-old female neonate presented with a protruding mass from the oral cavity since birth with associated respiratory distress and feeding problems. On examination she was in respiratory distress having supraclavicular and subcostal retraction, with a grey-white mass protruding through the mouth. A neurocranium CT scan revealed a cystic mass at the oropharynx measuring 5.4 cm × 4 cm. Transoral excision of the mass was done, and a subsequent histopathologic examination and immunohistochemistry for glial fibrillary acidic protein (GFAP) confirmed the diagnosis of glial heterotopia. CLINICAL DISCUSSION: GH most commonly involves the nose, although there are reports of its occurrence in the lips, tongue, scalp, and oropharynx. Preoperative imaging is essential to exclude intracranial connection. Complete excision is the treatment of choice, and histopathology provides a definitive diagnosis.

conclusionGlial heterotopia can rarely occur in the oropharynx, and it can be unusually large to cause airway obstruction. Clinicians should consider glial heterotopia in newborns presenting with a cystic oropharyngeal mass.