Nasal glioma

Glioma, also known as “glial heterotopia” is a non-neoplastic lesion consisting of neuroglial tissue without the communication to the central nervous sytem.  It commonly occurs at birth or within 1-2 years of life; and has no genetic predisposition.  Glioma can be categorized as extranasal, intranasal, or mixed lesions.  Extranasal lesion (as seen here) is the most common form, comprising approximately 60% of all glioma.  It presents as a 1-3cm subcutaneous firm mass along the bridge of the nose. 

Astrocytes and neuroglial fibers are present along with fibrous and vascularized tissue (low mag: left; high mag: right).  Neurons are rarely seen.  Immunocytochemistry with glial fibrillary acidic protein (GFAP) antibody can be performed to confirm the presence of neuroglial tissue.

Gliomas are common in the first few years of life, but can occur in any age group. Symptoms can vary depending on the location of the lesion. Prior to biopsy or surgical resection of the lesion, one should obtain a CT scan to rule out the possibility of communication to the cranial cavity (e.g., encephalocele) or other potential CNS involvement. When evaluating the patient, the clinician can apply pressure on the ipsilateral jugular vein to elicit swelling or pulsation of the lesion (Furstenberg test). The presence of these findings highly suggests an encephalocele. Treatment is complete resection of the lesion. Incomplete resection results in recurrence of the lesion.