2017 Volume 53 Issue 5 Pages 1059-1063
The patient was a boy who was newly born by vacuum extraction at 40 weeks and 2 days of gestation and weighed 2,730 g. A mass was observed on the left side of the patient’s neck and the patient showed respiratory impairment that gradually worsened. The patient consequently underwent endotracheal intubation at 2 days postpartum. Computed tomography and ultrasonography revealed a multilocular mass, leading to the diagnosis of a lymphangioma. The patient subsequently underwent sclerotherapy, but no reduction in tumor size was observed. Magnetic resonance imaging also showed a multilocular mass centered around the parapharyngeal space, with part of the mass extending from the nasopharynx to the oropharynx. Because the nasopharyngeal and oropharyngeal involvement of the mass was considered to be the direct cause of respiratory impairment, endoscopic resection was performed at 31 days postpartum. Histopathological analysis revealed heterotopic glial tissue. Heterotopic glial tissue in the parapharyngeal space in newborns has been found in less than 20 cases worldwide, and the current case is the only one being reported in Japan. On imaging, heterotopic glial tissues are difficult to differentiate from lymphangiomas and teratomas; however, a mandibular deformity is said to be characteristically associated with heterotopic glial tissue. Therefore, when a mass is particularly observed in the neck of newborns, it is important to differentiate the lesion, considering a possible diagnosis of heterotopic glial tissue.
