Ectopic orbital brain tissue with perineural cerebrospinal fluid leakage: a case report

A newborn girl presented with perinatal left periorbital swelling and was treated with antibiotics for 7 days, without improvement. At 9-days-old, ophthalmic examination showed an inferomedial soft, palpable, mobile mass with prominent dilated overlying conjunctival vessels and a morning glory optic disc anomaly of the left eye. Magnetic resonance imaging (MRI) revealed a complex, multilobulated mass displacing the globe superolaterally. Subtotal excision revealed benign ectopic brain tissue. Subsequently, swelling and proptosis recurred. Computed tomography (CT) with cisternogram showed cerebrospinal fluid (CSF) leakage from the optic nerve sheath into the mass. The mass was successfully excised resulting in a satisfactory outcome. This case highlights an association between ectopic brain tissue and CSF leakage, which may be found using CT cisternogram for diagnosis and surgical planning.