Background: Glial heterotopia is a rare, nonneoplastic extracranial displacement of the brain tissue, most commonly seen on the nose.

Clinical Description: A 2-year-6-month-old boy presented with a nasal mass that had gradually increased since birth, being otherwise asymptomatic. The mass was firm, tense, predominantly skin colored with some bluish discoloration, with no signs of inflammation, present on the left side of the bridge of the nose. Systemic examination and vitals were normal.

Management and Outcome: Contrast-enhanced magnetic resonance imaging scan showed features suggestive of nasal glial heterotopia (NGH), with a thin linear T2-weighted hyperintense stalk extending from the mass up to the foramen cecum. Complete surgical excision, with ligation and cauterization of the fibrous communicating tract, was done close to the intracranial entry. Histopathology confirmed the diagnosis of glial heterotopia, with immunohistochemistry showing glial fibrillary acid protein positivity.

Conclusion: Pediatricians need to be aware that a slow-growing external nasal mass, present since birth, may be an NGH. Imaging can delineate intracranial connections with confirmation by histopathology after complete excision 

Suchitra Pusapati is an Associate Professor in the Department of Paediatrics at GITAM Institute of Medical Sciences and Research (GIMSR), Visakhapatnam, India. She completed her MRCPCH and paediatric training in the United Kingdom, bringing with her a strong foundation in evidence-based paediatric care and international clinical experience. With over a decade of dedicated involvement in undergraduate and postgraduate medical education, Dr. Pusapati is also deeply committed to academic excellence. She has furthered her expertise with an MBA in Hospital and Health Systems Management and has completed the prestigious Advanced Course in Medical Education (ACME), enhancing her leadership and pedagogical skills in medical academia. She continues to contribute to the advancement of paediatric healthcare and education through her clinical work, teaching, and ongoing research.