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Pathology & Laboratory Medicine

URMC / Pathology & Laboratory Medicine / Education / Case of the Month / Case 41: Posterior Tongue Nodule / Diagnosis

 

Diagnosis

Diagnosis

Osseous Choristoma

Discussion

The term Choristoma refers to histologically normal tissues in a location other than the sites at which they are normally detected. This stands in contrast to hamartoma, which refers to a collection of disorganized histologically normal and mature tissues typically found in that location.

Choristomas are rare benign tumor-like masses that frequently occur in the tongue. They have been described in various other locations in the head and neck region, such as the submandibular region, the masticator muscles, the retromolar pad, the buccal and alveolar mucosa. While several different types of choristomas have been described in the oral cavity (bone, cartilage, gastric mucosa, glial tissue, sebaceous glands), the most frequent observed choristoma of the oral cavity consists of bone.

Lingual osseous choristomas show a slight female predilection and present at a wide age range (5 – 73 years) with an average age of 30. The majority of lingual osseus choristomas occurs in the posterior tongue in proximity to the foramen caecum and the circumvallate papillae. They vary in greatest diameter from a couple of millimeters up to multiple centimeters. The majority of lingual osseous choristomas are found in the vicinity of the foramen caecum and the circumvallate papillae.

The pathogenesis of these lesions remains unclear. The literature discusses different theories, such as ossification of branchial arch remnants, ossification of remnants of underdescended intraglossal thyroid tissue, or ossification of a degenerating fibroma or posttraumatic ossification.

Complete excision is the curative treatment of choice. Recurrence following complete excision and malignant transformation have not been reported.

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References

Andressakis DD, Pavlakis AG, Chrysomali E, Rapidis AD. Infected lingual osseous choristoma. Report of a case and review of the literature. Med Oral Patol Oral Cir Bucal 2008;6.

Johann ACBR, Garcia BG, Nacif TR, de Freitas JB, do Carmo MAV, Mesquita RA. Submandibular osseous choristoma. J Craniomaxillofac Surg 2006;34(1):57–9.

Wenig, B.M. 2015; Atlas of Head and Neck Pathology (3rd Edition). Elsevier, Philadelphia, Pennsylvania.