Intraoral osseous and cartilaginous choristomas: report of three cases and review of the literature

Case reports of oral choristomas and a review of the literature

Choristomas are proliferative growths that occur when normal tissue develops in abnormal locations and may resemble tumors. Oral choristomas commonly present as slow-growing, indolent, and firm masses. The diagnosis primarily relies on histopathologic examination. Given their tumor-like growth and developmental pathogenesis, it is critical to differentiate them from neoplasms. In this article, we present two clinical cases of oral choristomas, a cartilaginous choristoma, and an osseous choristoma of the tongue. We also offer a brief review of the literature discussing clinical presentation, microscopic features, and therapeutic options.

Tongue Osseous Choristoma in an Adolescent Female: A Case Report

Lingual osseous choristoma is a rare, benign, bony tumor without clear pathogenesis. Most patients present with an asymptomatic lump in the posterior tongue, while others may suffer from globus sensation, dysphagia, gagging, or irritation. Here, we present a case of lingual osseous choristoma in a pediatric patient managed with surgical excision.

Intraoral osseous choriostoma---Case report and review on its biological occurrence

The terminology choriostoma describes a tumor-like lesion belonging to hamartomatous group of pathology, that is, normal tissue found in abnormal location. Osseous choriostomas in oral cavity are rare and mostly the cases have been reported in tongue but rarely arising from the interdental gingiva. There are various pathological entities arising from gingiva that give a thought of wider differential diagnosis starting from inflammatory to traumatic origin. Hamartomas in oral cavity are very rare which can definitely be attributed to the sparse literature which leads to misdiagnosis as well failure to understand its biology. In this report, we present a case of osseous choriostoma arising from interdental gingiva in a young female patient in the lower arch.

Tongue Osseous Choristoma in an 11-Year-Old Female: A Case Report and Literature Review Focusing on Pediatric Cases

Osseous choristoma is an uncommon benign lesion characterized by the presence of ectopic mature bone within soft tissue. In most cases, these lesions occur on the dorsum of the tongue in patients in their third and fourth decades of life. This article describes a case of lingual osseous choristoma in a pediatric patient. An eleven-year-old girl with a lingual mass was referred to our hospital from a dental clinic. Total excisional biopsy and histological examination were performed, and osseous choristoma was diagnosed. The postoperative course was uneventful with no signs of recurrence during the 12 months after surgery. Moreover, a literature review focusing on pediatric cases with lingual osseous choristoma was performed to know the etiology, clinicopathological characteristics, and course of treatment of the lesion.

A Case of an Incidentally Removed Lingual Osseous Choristoma

Lingual osseous choristoma is a rare benign tumor consisting of normal matured bone tissue. It was first reported in 1913, and less than 100 cases of lingual osseous choristomas, mainly in their twenties and thirties, have been reported in the English literature until now. Here, we report an additional case of lingual osseous choristoma, in an elderly patient, that was incidentally removed by coughing and cured without additional interventions. An 89-year-old male patient was referred to our department for an evaluation of chronic cough. When we examined his oral cavity and pharynx, he expectorated a 10 -mm mass which was histologically diagnosed as an osseous choristoma. We confirmed the well-defined, rounded, high-density mass with a tiny pedicle on the base of the tongue in previous cervical spine CT images. No signs of recurrence were found during the 15-month follow-up examination. Our case serves as a reminder of this rare entity in the diagnosis of tongue masses of the elderly.

Osseous choristoma of the tongue: A case report with dermoscopic study

Osseous choristomas are rare benign lesions characterized by ectopic bone formation in the soft tissue of the head and neck region. Dermoscopy visualizes the morphological characteristics that are not observable by the naked eye, and may be used for the evaluation of calcification under the skin. The present study reports a case of an osseous choristoma arising in the tongue, and reveals the dermoscopic features of osseous choristoma from a surgical specimen. A 7-year-old boy was referred to the Department of Dentistry and Oral Surgery, with an asymptomatic pedunculated mass in the tongue. The lesion was removed completely with the adjacent normal tissue under general anesthesia. Dermoscopy of the surgical specimen revealed the hypovascular and homogeneous pattern of the lesion with round extruded whitish material. Based on dermoscopic findings, the presence of calcified hard tissue in the submucosa was verified by the dermatologist. Radiographic examination of the surgical specimen revealed the lesion contained a radiopaque trabeculated mass. Histologically, the lesion contained an osseous tissue, and the pathological diagnosis of osseous choristoma was made following consideration of the ectopic bony tissues that were localized away from the maxillo-mandibular bone. The postoperative course was uneventful with no signs of recurrence during the 36 months following surgery. To the best of the author's knowledge, this is the first report of evaluation of osseous choristoma using dermoscopy. The observation indicates the usefulness of dermoscopy for the diagnosis of oral ossified lesion in oral soft tissue.

Osseous choristoma of submental region: A rare occurrence

Osseous choristoma is a rare, benign lesion of the oral cavity. This report presents a case of osseous choristoma in the submental region of a 30-year-old female subject. Her chief complaint was a painless swelling in the submental region. Panoramic radiography showed a well-defined, round, radiopaque lesion near the inferior border of the left mental region. The lesion was diagnosed as an osseous choristoma based on the histopathological examination of the surgical specimen. This paper is an attempt to bring forward a unique occurrence of osseous choristoma, which would further help the medical fraternity in improvising their knowledge, diagnosis, and treatment of this entity.

Palatal Osseous Choristoma

Osseous choristoma of soft tissue in the oral cavity is rare. The choristoma is a tumor-like mass of normal cells in an abnormal location. In this report, a case of osseous choristoma of the palate in a 37-year-old male patient was reported. Approximately 6 × 5 mm pedunculated healthy colored and hard mass was observed in the median palate. The mass was surgically removed. Microscopic examination of the hematoxylin and eosin-stained sections of the mass revealed that a dense lamellar bone nodule was surrounded by fibrous connective tissue under the squamous epithelium. Immunohistochemical analysis revealed that the mass was negative for S-100 protein, cytokeratin, and epithelial membrane antigens. According to these findings, the final pathologic diagnosis confirmed that the mass was an osseous choristoma.

Osseous choristoma of the labial mucosa: A rare case report

Osseous choristoma is a normal bone tissue in an ectopic position. These are slow growing lesions that are usually completely asymptomatic and only present when there is a disruption in the function of the organ due to its large size as it grows. Definitive diagnosis is obtained only after the histopathological examination. The etiology remains still questionable. The treatment of choice is surgical excision. Here we report a case of choristoma in the lower labial mucosa in a 47-year-old female.

Epidermal Choristoma of the Tongue Mimicking a Congenital Melanotic Macule

We report the fifth case of epidermal choristoma of the oral cavity in a Caucasian newborn with a congenital melanotic macule on the dorsum of the tongue. Epidermal choristoma is an exceedingly rare and benign condition probably caused by a developmental abnormality. It is identified according to the presence of normal skin in an abnormal location. Histologically it is identified according to areas of stratified epithelium and hyperpigmentation of the basal layer along with cutaneous adnexal structures (hair follicles, sebaceous or sweat glands). The clinical presentation is variable, but most of the cases described presented with a congenital lingual pigmented macule. These lesions should be included within the differential diagnosis of congenital lingual macules and distinguished from other entities such as congenital lingual melanotic macules and melanocytic lesions. Surgical excision is the treatment of choice. Epidermal choristoma is a benign condition that probably is underdiagnosed because it is a new and rare entity, and dermatologists should be aware of it.

Osseous choristoma of the tongue: a review of etiopathogenesis

Osseous choristoma is a normal bone tissue in an ectopic position. In the oral region lingual localization occurs more frequently and the mass is generally localized on the dorsum of the tongue. Definitive diagnosis is obtained only after histopathologic examination. The etiology remains already debatable. The treatment of choice is surgical excision. In this paper we present a case of tongue osseous choristoma and a review of the literature.

Cartilaginous choristoma of tonsil: A hidden clinical entity

Choristomas are aggregates of microscopically normal cells or tissues in aberrant locations. Cartilaginous choristomas of the oral cavity are rare and occur preferentially on the tongue and less often in sites such as the soft palate and gingiva. We report a case of cartilaginous choristoma in a 24-year-old male presenting with persistent tonsillitis. Histopathological examination demonstrated the presence of mature island of hyaline cartilage surrounded by lymphoid hyperplasias.

Osseous choristoma of the periodontium

Osseous choristoma is a rare, benign lesion of the oral cavity occurring usually on the tongue. It appears as a tumorous mass of normal bony structure with mature cells in an ectopic position. Some lesions represent developmental malformations, whereas others may be reactive lesions, after trauma or chronic irritation. This is the first ever reported case of an osseous choristoma of the periodontium in the lingual aspect of posterior mandible.

Chondroid choristoma: report of a rare case

An 11-year-old girl reported with an intraoral swelling which was noticed by her mother at birth and increased to its present size during the last year A thorough clinical examination did not shed a conclusive diagnosis. This case highlights and discusses the history, clinical features, histologic features, differential diagnosis and the clinical management of this lesion. Awareness of such an entity will enrich the knowledge of the pediatric dentists who may be the first ones to encounter such cases in their day-to-day practice.

Osseous choristoma of the submandibular region: case report

This report presents a case of osseous choristoma in the submandibular region of a 33-year-old female. Her chief complaint was painless swelling in the submandibular region. Panoramic radiography showed a well-defined, round, radiopaque lesion near the inferior border of the right mandibular angle. Coronal and sagittal tomographic images indicated a high-density area in the right submandibular region with no bony connection. The lesion was diagnosed as an osseous choristoma based on histopathological examination of the surgical specimen. A 1-year follow-up period was uneventful.

Submandibular osseous choristoma

PURPOSE

Osseous choristoma is a rare, benign lesion of the oral cavity and is usually found in the tongue. It presents as a tumour-like mass of normal bony structure with mature cells in an abnormal position. The object of this paper is to report one case of osseous choristoma.

PATIENT

A 32-year-old male presented with a lesion in the submandibular region, which was treated by excision. After 28 months of follow-up there was no recurrence.

CONCLUSION

Upon reviewing the English literature, no previous case of an osseous choristoma located in the submandibular region has been found. Extended clinical and radiographic follow-up is necessary after surgical excision of an osseous choristoma, despite its benign nature.

Mesenchymoma: an unusual tumour of the lip

The purpose of this paper is to present a case report of a benign mesenchymoma involving the lip. A brief review of relevant literature is presented.

Metastatic calcification of the nasal septum presenting as an intraoral mass: a case report with a review of the literature

Metastatic calcification is a pathologic condition characterized by deposition of calcified product in otherwise normal tissues as a result of hyperphosphatemia with or without concurrent hypercalcemia. Metastatic calcification presenting clinically as an oral lesion is extremely rare. To date, only 7 cases of metastatic calcification involving the oral soft tissues have been described. This report describes a case of metastatic calcification of the nasal septum presenting as a mass of the anterior maxillary vestibule in a patient with end-stage renal disease. The case reported is only the second example with nasal septum involvement. A brief review of the clinical and histopathologic features of previously reported intraoral cases is also presented.

Cartilaginous choristomas of the tongue: review of the literature and report of three cases

Three cases of cartilaginous choristomas of the tongue are presented. Two lesions occurred in women of 71 and 28 years of age whose lesions were located in the middle third of the dorsum. The other lesion was found on the left lateral border in a 27-year-old man. The clinical, microscopic and immunohistochemical features are described. The lesions were easily excised with no recurrence after follow-up periods of at least 6 months. The histogenesis and the differential diagnosis are discussed, and the literature is reviewed.

Lingual Osseous Choristoma: A Study of Eight Cases and Review of the Literature

A choristoma is a tumor-like mass of normal tissue in an “abnormal” location. Lingual osseous choristoma, previously known as osteoma of the tongue, is a rare entity: we found documentation of eight cases at our center during the 10-year period between 1987 and 1996. These cases were analyzed along with 50 others reported in the English language literature between 1913 and 1996. Lingual osseous choristoma frequently occurs during the third and fourth decades of life, and predominantly affects women (81 %). Most of the osseous choristomas in our review were located in the posterior third of the tongue, primarily at or close to the foramen cecum or circumvallate papillae (87.9%). While 39.7% of the patients were asymptomatic, the remaining patients complicated of symptoms including a lump in the throat (25.8%), dysphagia (6.9%), gagging (5.1%), nausea (3.4%) and irritation (3.4%). Treatment of lingual osseous choristoma consists of simple excision. The tumor's origin has been discussed elsewhere.

Lingual osteoma: a debatable entity

PURPOSE

This article analyzes osseous lesions in the tongue with regard to the clinical and histologic features and discusses the pathogenesis and terminology of these lesions.

MATERIALS AND METHODS

Thirty-eight cases of lingual osseous lesions were retrieved from the English language literature, and two new cases were added.

RESULTS

The lesions had a female predilection, with a female-to-male ratio of 2.3:1. Mean age of the patients at time of diagnosis was 31.4 years. The lesions were located in the posterior third of the dorsum of the tongue in 67.5% of the cases, in the lateral margins in 25%, and in the mid-third of the tongue in 7.5%. Size ranged from 0.5 to 5.0 cm. Duration of the lesions ranged from several months to 50 years. In eight cases, there was information that the lesions had increased in size. Histologically, the lesions appeared a well-circumscribed mass of vital bone under the surface epithelium. The two new cases, when examined by polarized light, showed a mixture of woven and mature bone.

CONCLUSION

The osseous lesions of the tongue represent a heterogeneous group of lesions in which some may represent a developmental malformation, and others may be a reactive lesion after trauma or irritation. Some lesions behave as true neoplasms and others as choristomas. It is suggested that the descriptive term "osseous tumorlike lesion of the tongue" may be more appropriate for this group.

Choristomas of the oral cavity: a review

The choristoma is a tumorlike mass of normal cells in an abnormal location. Intraoral choristomas have been reported under a wide variety of names. This comprehensive review of the English-language literature on oral choristomas offers a classification of these lesions, analyzes their clinical and histologic features, and discusses possible pathogeneses and treatment.

Recurrent intraoral osseous choristoma. Report of a case

The osseous choristoma of buccal soft tissue (intraoral soft tissue osteoma) is a rare entity that is reported not to recur after removal. A case involving the first documented recurrence of such a lesion is reported, and a review of the literature is presented.

Chondroma and osteochondroma of the tongue

The first case of two separate tumors of the tongue, one cartilaginous and the other osteocartilaginous, is reported. The cartilaginous matrix of these two tumors contained elastic fibers and type II collagen. The histogenesis of these tumors is discussed.