Lingual Osseous Choristoma: Case Presentation and Review of Literature

Abstract

Lingual osseous choristoma is an extremely rare condition, of which only 61 cases have been reported. Monserrat in 1913 was the first to report this bony lesion on the dorsum of the tongue and it was labelled as lingual osteoma, the term that normally describes neoplastic pathology. Krolls et al changed this term later to osseous choristoma, which means normal tissue in an abnormal location. The aetiology and pathogenesis of lingual osseous choristoma remain debatable. We report a case of lingual osseous choristoma and review the literature.

Neonatal lingual choristoma with thyroid hemiagenesis

“…It has been postulated that remnants of undescended thyroid or heterotopic epithelial cells of the respiratory and digestive tract can get embedded in the developing tongue and predispose to the development of a choristoma. The reactive theory suggests that constant irritation and inflammation of the posterior lingual surface can predispose to the development of a choristoma 1 2 5 7 8. In our case, we had the development of a choristoma in the posterior one-third of the tongue and thyroid hemiagenesis.…”

“…It is common in early childhood and the literature places the mean age at 5½ years and median age at 6 months. The male to female sex ratio is 1.6:1 1 2 7 8. Average cyst size range is 1 to 6.5 cm with a mean of 2.3 cm 1 2 7.…”

“…The male to female sex ratio is 1.6:1 1 2 7 8. Average cyst size range is 1 to 6.5 cm with a mean of 2.3 cm 1 2 7. The commonest site for a lingual choristoma is the anterior two-thirds of the tongue and floor of the mouth.…”

“…In the newborn, the most common presentation is impaired feeding and choking spells. In children and adults, presentation is usually in the form of an asymptomatic lump in the throat, dysphagia, gagging, nausea and throat irritation 1 3 7 11. Clinical examination usually reveals a mass at the site of lesion.…”

“…Care has to be taken to maintain the airway postoperatively due to presence of oedema and possible airway obstruction. Normal diet can be resumed 1–3 days following the operative procedure 1 3 7 8 11 12…”