Chen Fang, Xu Hongming, Gu Meizhen, Li Xiaoyan
Department of Otorhinolaryngology and Head & Neck Surgery, Shanghai Children's Hospital, Shanghai Jiaotong University, Shanghai, China.
Medicine (Baltimore). 2018 Dec;97(50):e13506. doi: 10.1097/MD.0000000000013506.
A choristoma formed by heterotopic tissue rarely occurs in the throat, especially one accompanied with cleft palate in a new-born baby.
An 18-month-old female patient was admitted to the hospital for apparent snoring symptoms accompanied by mouth breathing and sleep apnea. In addition, the patient presented with weak aspiration and nasal leakage during fluid intake.
The patient received routine physical examination and endoscopy showing that there was a wide fissure which split from the palate vertical anterior cleft to 1/3 of the hard palate. Meanwhile, we found an unclear-bordered uplift in the left palate and a soft mass. The radiographs revealed a mass with inhomogeneous density convex to the pharyngeal cavity.
The patient was subsequently referred for surgical resection and tissue diagnosis of choristoma was confirmed by pathological examination. H&E staining showed well demarcated mature brain tissue with scattered sand-like calcification.
According to the diagnosis, the patient suffered from pharyngeal glial choristoma and incomplete cleft palate. The surgical resection and repair were performed together. The postoperative recovery was very good.
Choristoma rarely occurs in the head and neck, especially if accompanied by cleft palate. Early diagnosis for choristoma relies heavily on clinical examination and radiological imaging. Complete resection of choristoma remains the gold standard for treatment of these patients.
由异位组织形成的迷离瘤很少发生于咽喉部,尤其是伴发于新生儿腭裂的情况。
一名18个月大的女性患者因明显打鼾症状伴张口呼吸和睡眠呼吸暂停入院。此外,患者在进食流质时出现吞咽无力和鼻漏。
患者接受了常规体格检查和内镜检查,结果显示存在一条从腭垂直前裂延伸至硬腭1/3处的宽裂隙。同时,我们在左侧腭部发现一个边界不清的隆起和一个柔软肿物。影像学检查显示一个密度不均匀、向咽腔凸出的肿物。
随后患者接受了手术切除,病理检查证实为迷离瘤组织诊断。苏木精-伊红染色显示界限清楚的成熟脑组织,伴有散在的砂粒样钙化。
根据诊断,该患者患有咽神经胶质迷离瘤和不完全腭裂。手术切除和修复同时进行。术后恢复良好。
迷离瘤很少发生于头颈部,尤其是伴发腭裂时。迷离瘤的早期诊断很大程度上依赖于临床检查和影像学检查。完整切除迷离瘤仍然是这些患者治疗的金标准。