Introduction:
Soft tissue masses in neonates often attract a wide variety of differential diagnosis, with hemangiomas and other types of vascular malformations being the most common benign lesions. However, in this mysterious case, neuroglial heterotopia, a rare congenital anomaly characterized by the presence of mature neural tissue outside the cranial cavity, was discovered instead. Extracranial presentations of these lesions are rarely encountered.

Aim:
This case report aims to create awareness regarding the possibility of neuroglial heterotopia masquerading as a benign tumor in neonates and to highlight the importance of examination and confirmation with radiological investigations, to guide further management.

Case study:
We describe a 3-month-old infant who presented with a rapidly growing soft, non-tender mass on the right side of her head that she had since birth. Radio imaging showed multiple cystic lesions located extra-temporally, which may represent lymphatic malformation, and excluded the chance of branchial cleft cyst as no intracranial sinus tract was seen.

Results and discussion:
Surgical excision of the mass was performed, and histopathological evaluation confirmed the presence of mature glial tissue consistent with neuroglial heterotopia.

Conclusions:
Extranasal neuroglial heterotopias are a distinct clinical entity. Accurate diagnosis, primarily using imaging, is essential to differentiate from other soft tissue masses in neonates and to guide management. Surgical excision remains the treatment of choice, and histopathological examination is required to confirm the diagnosis.