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

Abstract

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.

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

“…Most pediatric patients with lingual osseous choristoma are females (4 males, 13 females). Although these findings are consistent with previous reports [ 4 , 54 ], we could not identify the reason for the sexual predisposition. The patients' ages ranged from 5 years to 11 years (mean 9.3 years, median 10 years using Excel function).…”

“…The patients' ages ranged from 5 years to 11 years (mean 9.3 years, median 10 years using Excel function). It has been demonstrated that most of the lesions develop as symptomless 3–50 mm masses located in the tongue's posterior third in the area of circumvallate papillae or close to the foramen caecum [ 4 , 54 ]. The findings reported in our manuscript are in line with previous reports.…”

“…The pathogenesis of osseous choristoma is not yet known, a “developmental malformation hypothesis” and a “chronic trauma-associated reactive hypothesis” were proposed [ 4 , 16 , 41 , 54 , 58 ]. The involvement of systemic diseases has not been reported.…”

Lingual Osseous Choristoma: A Case Report and Review of the Literature

“…Histopathologically, lingual osseous choristoma is submucosally located and consist of well-developed lamellar bone and Haversian system. Osteoblastic and osteoclastic activity, cytological atypia or mitosis are not observed in the bone tissue [10].…”

A Case of an Incidentally Removed Lingual Osseous Choristoma

“…Less than 100 cases of osseous choristomas of the oral and maxillofacial region have been reported in the English language literature, and the most common site is the tongue, especially the dorsal posterior third of the tongue near the foramen caecum and circumvallate papillae [5]. Gorini et al provided a comprehensive review of 67 cases of the lingual osseous choristomas [6], and eight additional cases of osseous choristoma of the tongue were reported since their review [5,[7][8][9][10][11][12]. Including newly reported cases and our case, the patients' age ranged from five to eighty-nine years (mean: 28.9), with majority of the patients being in the second or third decades of life, and a strong female predilection (male : female, 19 : 50) was observed.…”