A seven year tribal male child presented with a painless swelling on the
upper part of the nose since birth which had gradually increased to the
present size (Fig.1). He has average intelligence and was
otherwise asymptomatic. He was being worshipped as Lord Ganesha because of
the typical appearance.
|
Fig. 1 A large mass of size 10×8×7 arising
from the root of the nose. |
Examination revealed a large, soft swelling of 10×8×7
cm in size arising from the right side of the root of the nose. Skin over
the swelling was hyperpigmented. There was cough impulse but no
trans-illumination A provisional diagnosis of frontal meningocele was
made. Differential diagnoses included dermoid cyst, hemangioma,
neuro-fibromatosis, rhabdomyosarcoma and encephalocele. Dermoid cyst,
hemangioma, and neuro-fibromatosis are easily distinguished by their
peculiar external appearance. Rhabdomyosarcoma is a rapidly progressing
tumor; a relatively benign appearance of this tumor after a long period is
against its diagnosis.
CT scan confirmed the diagnosis of right frontonasal
encephalomyelocele with partial corpus callosal agenesis. He was referred
to a higher center for surgical management.