Multiple Oral Mucosal Hamartomas in a 34-Year Old Female

Abstract

reported first noticing these lesions approximately 10 years prior. She also denied any history of oral surgery, facial trauma, and alcohol, tobacco, or recreational drug use. The patient's past medical history was significant for left and right mastectomy for bilateral ductal carcinoma and partial thyroidectomy for microcarcinoma. She received blood transfusions at multiple points during her surgical journey but her current medical regimen included only levothyroxine. Clinical FindingsIntraoral examination (Fig. 1) revealed generalized multiple white-pink round/oval papules on the patient's lips. She was noted to have a distinct 6 mm × 5 mm × 3 mm papillary lesion on the facial gingiva between teeth #25 and 26 with smaller lesions extending slightly inferiorly to the distal of teeth #27 and 28. Similar small patches of lesions were noted on her contralateral mandibular quadrant. Also noted was a 7 mm × 3 mm white lesion on her right buccal mucosa just superior to the occlusal plane on the distobuccal cusp of tooth #31. In addition, pink papillary growths were found on the palatal gingiva of teeth #1, 2, 3, 6, 7, 9, 10, and 11 (Fig. 2) along with a similar but white papillary lesion on the attached buccal gingiva of tooth #15 measuring 5 mm × 5 mm × 5 mm. Another 3 mm × 7 mm papillary cluster was noted on the lingual mandibular gingiva near teeth #21 and 22. White gingival tissue was noted on the crest of her #14 edentulous ridge site (Fig. 3). None of these lesions were removable with gauze. The tongue was otherwise normal, as was the floor of her mouth. Radiographic imaging of the maxillomandibular region was otherwise unremarkable.Abstract A case of Cowden syndrome (CS) is described in a 34-year-old African American female who reported a history of breast and thyroid malignancies. Clinical examination demonstrated multiple soft, white-pink papules across multiple mucosal surfaces of the oral cavity. Microscopy of the lesions revealed hyperkeratotic surface squamous epithelium with papillomatosis and acanthosis along with elongated rete processes. A genomic polymerase chain reaction direct sequencing using the patient's blood was positive for mutations of the PTEN gene typical of CS.

Giant sublingual hamartoma with medial cleft tongue: a case report and literature review

“…2,4 The locations of hamartomas in the oral cavity have comprised the tongue and oral mucosa. 5,6 To the best of our knowledge, no sublingual hamartomas with medial cleft tongue have been reported in the international literature, although partial duplication of the face was described in a patient with cleft palate, duplicated tongue, hamartoma of the oral floor, and lower cleft lip. 7 Although medial cleft tongue differs from bifid tongue in terms of the extent of anomaly, the terms "cleft tongue" and "bifid tongue" are used interchangeably.…”

Non-HPV Papillary Lesions of the Oral Mucosa: Clinical and Histopathologic Features of Reactive and Neoplastic Conditions

“…Oral papillomatosis is part of a variety of skin disorders and syndromes ( Table 1). The development of multiple sessile papillomatous, white-pink, coalescent papules on the keratinized and non-keratinized oral mucosa can be an early clue toward diagnosis of multiple hamartoma syndrome [36]. The sudden onset of florid papillomatosis of the lips, labial commissures or oral mucosa is characteristic of acanthosis nigricans, a paraneoplastic condition associated with gastrointestinal malignancy (Fig.…”