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Yancoskie AE, Trochesset DA, Merer D, Fantasia JE, Kumar AM. Oral leiomyomatous hamartoma: presentation of 3 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:e1-e7. [PMID: 38619102 DOI: 10.1016/j.oooo.2023.07.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/05/2023] [Accepted: 07/26/2023] [Indexed: 04/16/2024]
Abstract
Oral leiomyomatous hamartoma (OLH) is a rare lesion, with only 40 cases reported in the literature. It typically presents early in life as a nodule on the anterior maxillary alveolar tissues or the tongue. Its growth potential is limited, with few cases reaching dimensions >2.0 cm, and its microscopic composition includes an intact surface mucosa with an underlying fibrovascular stroma possessing an unencapsulated proliferation of smooth muscle fascicles. Excision is considered the definitive treatment. Here we describe the clinical, microscopic, histochemical, and immunohistochemical features and management of 3 cases of OLH and review the literature. The findings we present here can assist in performing differential diagnosis, particularly in discriminating between OLH and similar yet non-hamartomatous processes and in selecting appropriate management.
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Affiliation(s)
- Aaron E Yancoskie
- Touro College of Dental Medicine at New York Medical College, Hawthorne, NY, USA; New York Medical College, Valhalla, NY, USA.
| | - Denise A Trochesset
- Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
| | | | - John E Fantasia
- Zucker Hofstra/Northwell School of Medicine LIJMC, New Hyde Park, NY, USA
| | - Arthi M Kumar
- Oral and Maxillofacial Pathology, Radiology and Medicine, New York University College of Dentistry, New York, NY, USA
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2
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Pérez-de-Oliveira ME, Robinson L, Assunção Júnior JNR, Abrahão AC, Romañach MJ, Penafort PVM, da Silva LC, Santos-Silva AR, Lopes MA, van Heerden WFP, Vargas PA. Tongue hamartomas in pediatric patients: an international case series and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:739-748. [PMID: 36241602 DOI: 10.1016/j.oooo.2022.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 06/10/2022] [Accepted: 06/20/2022] [Indexed: 12/13/2022]
Abstract
This study reports 9 additional tongue hamartomas in children paired with a literature review. A retrospective analysis was performed from 3 Oral Pathology laboratories. Additionally, a literature review was conducted through 5 electronic databases and gray literature. A total of 9 cases were identified in the retrospective analysis. Females outnumbered males with a ratio of 1.25:1. The age of presentation ranged from 2 weeks to 7 years. The posterior dorsum tongue was the most affected subsite (n = 4). One case was seen in a patient with oro-facial-digital syndrome, 2 cases in patients with cleft palates, and one case with an encephalocele. The most common predominant component was salivary gland tissue (n = 4). A literature search included 79 pediatric patients presenting with 95 tongue hamartomas. A slight female (n = 47) predilection was observed, with ages varying from 15 hours to 19 years. The posterior tongue dorsum (n = 31) was the most affected site. Seven cases were seen in association with syndromes. The most common predominant component was smooth muscle (n = 35). Although hamartomas are rare in the oral cavity, they should be considered in the differential diagnosis of masses involving the posterior tongue dorsum in children.
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Affiliation(s)
| | - Liam Robinson
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | | | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Luan César da Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Willie F P van Heerden
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), São Paulo, Brazil; Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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3
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A Case of an Infantile Lingual Leiomyomatous Hamartoma. Case Rep Otolaryngol 2022; 2022:5377771. [PMID: 36267430 PMCID: PMC9578814 DOI: 10.1155/2022/5377771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/07/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022] Open
Abstract
Lingual leiomyomatous hamartomas are rare lesions of the tongue with largely unknown mechanisms of formation. These lesions are often asymptomatic, though they may present with symptoms, particularly relating to swallow function. Workup should include imaging of the head and neck, and diagnosis should be made histologically. Treatment is surgical excision. This case is a report of a 4-week-old female who presented for evaluation of an asymptomatic 1 × 1 cm dorsal midline tongue mass discovered at birth. The patient was monitored until the age of 9 months, at which time the mass was surgically excised. The patient had an uncomplicated postoperative course. Pathological analysis yielded a diagnosis of leiomyomatous hamartoma.
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Liu YCC, Shih M, Hicks MJ, Sitton MS. Lingual Hamartomas: Clinical Characteristics, Diagnostic Evaluation, Treatment, and Outcomes. Laryngoscope 2020; 131:E2080-E2088. [PMID: 33258484 DOI: 10.1002/lary.29284] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/14/2020] [Accepted: 11/17/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVES/HYPOTHESIS To further clinically characterize lingual hamartomas, and to consolidate literature by analyzing clinical presentation, diagnostic evaluation, treatment, and outcomes. STUDY DESIGN Retrospective chart review and literature review. METHODS Case series from 1989 to 2020 at a tertiary pediatric center; follow-up ranging from 2 months to 12 years. Patient demographics, clinical presentations, physical examination findings, surgical pathology, operative methods, pre-operative imaging, and follow-up. A review of English-language literature from 1945 to 2020 was conducted. RESULTS Seven patients (four male, three female) with nine lingual hamartomas were identified. Average age at surgical excision was 7.9 months (SD 3.5 months, range 3 to 14 months). Follow-up ranged from 2 months to 12 years, with all patients having no recurrence. Physical examination identified five pedunculated hamartomas and two sessile hamartomas. One patient had a neck CT, one had neck ultrasound, and two had facial MRIs. CT and ultrasounds confirmed presence of cervical thyroid. MRI suggested no muscular invasion for one patient, whereas motion artifact obscured findings for the other patient. Most patients who presented with dysphagia or poor weight gain achieved post-surgical improvement. The present cases combined with the literature review identified 57 patients with 63 lingual hamartomas. CONCLUSIONS Lingual hamartomas appear as hypovascular pedunculated masses near the foramen cecum. There is no demographic predisposition, and most are identified during infancy. Imaging is not necessary, unless there is concern for lingual thyroid, in which case thyroid ultrasound should be performed. Surgical excision is curative, with dysphagia resolution and low likelihood for recurrence. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E2080-E2088, 2021.
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Affiliation(s)
- Yi-Chun Carol Liu
- Division of Pediatric Otolaryngology, Texas Children's Hospital, Houston, Texas, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Michael Shih
- Baylor College of Medicine, Houston, Texas, U.S.A
| | - M John Hicks
- Department of Pathology, Texas Children's Hospital, Houston, Texas, U.S.A.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Matthew S Sitton
- Division of Pediatric Otolaryngology, Texas Children's Hospital, Houston, Texas, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, U.S.A
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5
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Sánchez-Romero C, Bonan PRF, Pires FR, Oliveira Silva-Junior G, Delgado Azañero W, Almeida OPD, Perez DEDC. Leiomyomatous Hamartomas of the Oral Cavity: Clinicopathological and Immunohistochemical Features of 4 Cases and Literature Review. Int J Surg Pathol 2019; 27:624-630. [DOI: 10.1177/1066896919843337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. To present 4 new cases of oral leiomyomatous hamartomas (OLH), describing its clinical, microscopical, and immunohistochemical features, and a literature review. Methods. The OLH cases were retrieved from the files of 2 Brazilian and 1 Peruvian oral pathology services. Clinical data were obtained from the pathology reports. Microscopical features were reviewed, and immunohistochemical reactions were performed. A review of the English-language literature about OLH was done. Results. The sample was composed of 3 females (4-, 10-, and 15-year-old) and 1 male (3-year-old). Three cases affected the dorsum of the tongue and one the incisive papilla, and all presented sessile or pedunculated smooth nodules. Microscopically, the lesions were composed of varying-size fascicles of smooth muscle fibers in a fibrous connective tissue background. Immunohistochemistry revealed positivity of the smooth muscle bundles for myogenic markers. The English-language literature review revealed 38 OLH cases reported, most were congenital or diagnosed up to 5 years old. The main locations were tongue and anterior maxilla. Conclusions. Although OLH is a rare lesion, it must be considered in the differential diagnosis of midline tongue or maxillary masses in newborns, infants, and youngsters.
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Dhua A, Kumar K, Nagendla M, Bhatnagar V, Mridha A. Lingual leiomyomatous hamartoma with bifid tip of tongue and ankyloglossia in an infant. ACTA ACUST UNITED AC 2017. [DOI: 10.1111/ors.12296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A.K. Dhua
- Department of Pediatric surgery; All India Institute of Medical sciences; New Delhi India
| | - K. Kumar
- Department of Pediatric surgery; All India Institute of Medical sciences; New Delhi India
| | - M.K. Nagendla
- Department of Pediatric surgery; All India Institute of Medical sciences; New Delhi India
| | - V. Bhatnagar
- Department of Pediatric surgery; All India Institute of Medical sciences; New Delhi India
| | - A.R. Mridha
- Department of Pediatric surgery; All India Institute of Medical sciences; New Delhi India
- Department of Pathology; All India Institute of Medical sciences; New Delhi India
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7
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Hemmaoui B, Sahli M, Jahidi A, Benariba F. Hamartoma of the tongue. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:295-296. [PMID: 28668318 DOI: 10.1016/j.anorl.2017.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- B Hemmaoui
- Service d'ORL et chirurgie cervico-faciale, faculté de médecine et de pharmacie, université Med V, hôpital d'instruction militaire Mohamed V, Rabat, Hay Riad, Rabat, Morocco.
| | - M Sahli
- Service d'ORL et chirurgie cervico-faciale, faculté de médecine et de pharmacie, université Med V, hôpital d'instruction militaire Mohamed V, Rabat, Hay Riad, Rabat, Morocco
| | - A Jahidi
- Service d'ORL et chirurgie cervico-faciale, faculté de médecine et de pharmacie, université Med V, hôpital d'instruction militaire Mohamed V, Rabat, Hay Riad, Rabat, Morocco
| | - F Benariba
- Service d'ORL et chirurgie cervico-faciale, faculté de médecine et de pharmacie, université Med V, hôpital d'instruction militaire Mohamed V, Rabat, Hay Riad, Rabat, Morocco
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