Lingual Osseous Choristoma: A Systematic Review of Lesion Presentation, Histology, and Morphology

Abstract

INTRODUCTION Osseous choristomas of the tongue are rare, benign tumor-like lesions composed of abnormally placed bone and cartilage tissue. The few publications to date concerning this condition have been primarily limited to case reports. This systematic review aimed to clarify the clinical presentations of osseous choristomas and how to delineate them from other oral pathologies. METHODS The authors utilized PubMed, Embase, and Cochrane Library reference databases from 1971 to mid-2020. Search terms were “osseous choristoma,” “oral cavity,” and “lingual.” Preferred Reporting Systems for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to aggregate relevant data from each study. The authors specifically collected data regarding patient demographics, clinical findings, symptoms, treatments, and subsequent outcomes relating to lingual osseous choristomas. RESULTS A total of 35 (14.6% of total identified) publications that met inclusion criteria were identified concerning a total of 69 lingual osseous choristoma cases. Results were compiled focusing on sex and age, presenting symptoms, histology, appearance of the lesion base being most commonly pedunculated (e.g., stalk or stem-like), the lesion’s location on the tongue, and subsequent treatments. Osseous choristomas had a higher rate of occurrence in females, 48 (70%) and those under the age of 40. Symptomatic presentations occurred in 38 (55%) patients, with the most common presenting symptoms being gagging/globus (i.e., lump or foreign body) sensation (n = 47, 68%) and dysphagia (n = 20, 29%). Identified masses were pedunculated in 33 (80%) of cases and eight (20%) were identified as sessile (i.e., immobile). A total of 41 (59%) lesions were more commonly located in the posterior one third of the tongue compared to 28 (41%) in the anterior two thirds of the tongue. Of those 49 (71%) cases requiring surgical mass excisions, recurrence was reported in 0% of cases. CONCLUSIONS Although osseous choristomas are benign processes that rarely arise from the tongue, providers should carefully inspect patients with a gagging/globus sensation and pedunculated mass toward the back of the tongue. Surgical resection remains the best treatment to prevent recurrence.

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

“…No evidence of spontaneous loss or malignant transformation has been reported. No case of pediatric lingual osseous choristoma showed any sign of recurrence [ 7 ], while only two recurrent nonpediatric cases of the buccal mucosa lesion were reported [ 56 , 57 ]. Long et al reported that the recurrent lesion could have arisen as a result of the surgical trauma caused by the removal of the original lesion; however, this theory could not explain the occurrence of the original lesion because the patient denied any history of trauma [ 56 ].…”

“…Lingual masses can include osseous choristoma or other lesions such as fibroma, papilloma, pyogenic granulomas, squamous cell carcinomas, or hemangiomas [ 6 ]. Even though some patients may be asymptomatic, a wide array of symptoms, including gagging, dysphagia, foreign body sensation, throat irritation, discomfort, and pain, have been reported [ 7 ]. Physical examination and diagnostic imaging may assist in identifying the mass; however, a definitive diagnosis requires histologic examination.…”

Coristoma óseo de la lengua: Reporte de un caso de etiología traumática

“…El coristoma es definido como el crecimiento de tejido normal en locaciones anormales, rara vez observado en cavidad oral y, cuando se presentan, son con mayor frecuencia compuestos de tejido óseo o cartilaginoso. Otras composiciones menos frecuentes incluyen tejido glial periférico, glándulas sebáceas o tejido gastrointestinal 1 . El coristoma óseo lingual se refiere al crecimiento heterotópico de tejido óseo maduro dentro de tejido blando lingual.…”

“…El coristoma óseo lingual se refiere al crecimiento heterotópico de tejido óseo maduro dentro de tejido blando lingual. Es una lesión rara y benigna de la cavidad oral que afecta más comúnmente el dorso de la lengua con menos de 100 casos reportados en la literatura desde su definición en el año 1913 1,2 . En ocasiones genera sintomatología de estimulación mecánica, como disfagia y náuseas.…”

“…La histología generalmente informa hueso laminillar compacto con canales de Havers bien desarrollados o cartílago maduro rodeado por tejido conectivo denso. El tratamiento de elección para esta patología es la exéresis quirúrgica con un pronóstico favorable y sin reportes de recidivas locales [1][2][3][4] .…”