Case Report/Case Series |

Glial Choristoma of the Temporal Bone in a 7-Month-Old Infant

Elizabeth Dunham, MD, MPH1; Mark Armeni, MD1
[+] Author Affiliations
1Department of Otolaryngology, West Virginia University, Morgantown
JAMA Otolaryngol Head Neck Surg. 2013;139(9):944-946. doi:10.1001/jamaoto.2013.4036.
Text Size: A A A
Published online

Importance  Heterotopic glial tissue is a rare, benign congenital anomaly that can present as a fibrous mass with or without overt signs of neural tissue origin, such as overlying alopecia, pigmentation, or a “hair collar” sign. These lesions are typically found in the midline area, though they have been found laterally involving the mastoid and middle ear regions. As demonstrated by this case report, a lateral scalp lesion may represent glial tissue even if fine-needle aspiration does not demonstrate neural findings.

Observations  This single case report represents a 7-month-old white infant who presented with a lateral scalp mass over the mastoid area. The mass enlarged as she grew, causing external auditory canal obstruction. Fine-needle aspiration demonstrated fibrovascular tissue, and computed tomographic imaging showed a small bony defect over the mastoid area but no intracranial communication. The final pathologic finding was consistent with glial choristoma, a rare, benign congenital lesion involving heterotopic neural tissue.

Conclusions and Relevance  Congenital scalp lesions can represent heterotopic neural tissue and warrant complete evaluation prior to treatment; fine-needle aspiration biopsy is not necessarily reliable to rule out neurogenic origin, as demonstrated in this case. The possibility for intracranial extension should always be considered and fully evaluated with computed tomography or magnetic resonance imaging prior to operative intervention. Most prior published case reports of heterotopic glial tissue involving the mastoid and/or middle ear spaces describe adults and suggest that such lesions were acquired later in life. This report of a lateral glial choristoma overlying the mastoid bone in an infant supports a congenital origin of this lesion.

Figures in this Article

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours


Place holder to copy figure label and caption
Figure 1.
Preoperative Photograph Demonstrating Anterior Displacement of the Pinna by a Postauricular Mass
Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.
Coronal Computed Tomographic Scan Showing a Mass With Dimple Into the Mastoid Cortex
Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.
Findings From Microscopic Examination Demonstrate Fibrillary Glial Tissue With Scattered Astrocytes, Oligodendrocytes, and Microglia
Graphic Jump Location
Place holder to copy figure label and caption
Figure 4.
Postoperative Photograph of the Left Ear Showing a Normal Pinna Position and Shape
Graphic Jump Location




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
PubMed Articles