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Jain N, Tyagi S, Khatri A, Narang E, Gupta A. Solitary Ganglioneuromatous Hamartoma Tongue in a Newborn - A Rare Entity. Indian J Otolaryngol Head Neck Surg 2024; 76:2145-2148. [PMID: 38566712 PMCID: PMC10982259 DOI: 10.1007/s12070-024-04496-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 01/02/2024] [Indexed: 04/04/2024] Open
Abstract
Ganglioneuromatous hamartoma is a benign tumour of autonomic ganglia with very few cases reported in head and neck region. In this report, we are presenting a case of ganglioneuromatous hamartoma in a 20 day old female child who presented with a tongue mass. She underwent a surgical excision and the definitive diagnosis was made by histopathology. This case reports discusses presentation and management of a case of ganglioneuromatous hamartoma.
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Affiliation(s)
- Neha Jain
- Department of ENT, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, 110031 India
| | - Sonali Tyagi
- Department of ENT, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, 110031 India
| | - Arti Khatri
- Department of Pathology, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, 110031 India
| | - Ekta Narang
- Department of ENT, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, 110031 India
| | - Aarshi Gupta
- Department of ENT, Chacha Nehru Bal Chikitsalya, Geeta Colony, New Delhi, 110031 India
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2
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Kennedy KL, Steele J, Cunningham MJ. A Congenital Tongue Mass. JAMA Otolaryngol Head Neck Surg 2023; 149:1147-1148. [PMID: 37733354 DOI: 10.1001/jamaoto.2023.2911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
A 13-month-old male presents with a firm left anterior tongue mass noted since birth that has increased proportionally with the child’s growth. What is your diagnosis?
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Affiliation(s)
- Kenneth L Kennedy
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Jasmine Steele
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Michael J Cunningham
- Boston Children's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Leonard JA, Blumenthal DL, Bauman NM, Rana MS, Peña MT, Espinel AG. Surgically treated pediatric tongue masses: A 20 Year review. Int J Pediatr Otorhinolaryngol 2023; 166:111486. [PMID: 36805845 DOI: 10.1016/j.ijporl.2023.111486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/05/2023] [Accepted: 02/09/2023] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Pediatric tongue lesions represent a rare, diverse group of pathologies related to congenital malformations, inflammatory changes, and neoplastic masses. We present the largest-to-date series of pediatric tongue lesions managed surgically. SETTING Charts of all pediatric patients with a tongue lesion surgically treated at a regional children's hospital from February 1st, 1997 to August 30th, 2019 were reviewed. METHODS After obtaining institutional review board approval, a retrospective review was completed of all pediatric patients with a tongue lesion surgically treated at a regional children's hospital from February 1st, 1997 through August 30th, 2019. Charts were evaluated for patient demographics as well as symptoms at presentation, surgical details, pathologic evaluation of the lesion, and rates of recurrence. Categorical variables were compared between various groups using Chi-square and/or Fisher's exact tests. Univariate and multivariable logistic regression analysis was performed unadjusted and adjusted to further explore these relationships. RESULTS 159 patients were included in the study with ages distributed relatively even across infants (27.7%), children 1-5 years (27.7%), 6-10 years (23.3%), and greater than 10 years of age (21.4%). Patient/family reported race/ethnic background was most commonly Caucasian (34.8%) or Hispanic/Latino/Spanish Origin (34.0%) followed by Black or African American (21.3%). The most commonly reported symptoms were pain (23.3%), difficulty with oral intake (12.6%), bleeding (11.3%), and respiratory distress (11%). Patients with lesions of the base of tongue were significantly more likely to present with respiratory distress or difficulty with oral intake (p < 0.001). The likelihood of recurrence was observed to be higher with lesions managed in infancy (OR 3.85, CI 1.47-10.0, p = 0.005), those greater than 2 cm (OR 3.45, CI 1.34-8.71, p = 0.009), or with laser (OR 4.52, CI 1.25-15.00), p = 0.015). CONCLUSION Pediatric patients with tongue lesions may present with a wide array of symptoms. Base of tongue lesions should be managed carefully as they are most likely to create barriers to the airway and oral intake. Larger lesions and those managed in infancy are at increased risk for recurrence.
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Affiliation(s)
- James A Leonard
- MedStar Georgetown University Hospital, Department of Otolaryngology-Head & Neck Surgery, Washington, DC, USA.
| | - Daniel L Blumenthal
- MedStar Georgetown University Hospital, Department of Otolaryngology-Head & Neck Surgery, Washington, DC, USA
| | - Nancy M Bauman
- Children's National Health System, George Washington University, Department of Otolaryngology, Washington, DC, USA
| | - M Sohel Rana
- Children's National Health System, George Washington University, Department of Otolaryngology, Washington, DC, USA
| | - Maria T Peña
- Children's National Health System, George Washington University, Department of Otolaryngology, Washington, DC, USA
| | - Alexandra G Espinel
- Children's National Health System, George Washington University, Department of Otolaryngology, Washington, DC, USA
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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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5
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Casellas NJ, Porterfield L, Faria J. An unusual case of oral Angiokeratoma circumscriptum in a pediatric patient. OTOLARYNGOLOGY CASE REPORTS 2022. [DOI: 10.1016/j.xocr.2022.100472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
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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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Kim HJ, Kim MB, Chang SW. Ventral Surface Midline Cavernous Hemangioma of Anterior Tongue in a Child. EAR, NOSE & THROAT JOURNAL 2022:1455613221080971. [PMID: 35229688 DOI: 10.1177/01455613221080971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hyun Jung Kim
- Department of Otorhinolaryngology, 91577Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Min Bum Kim
- Department of Otorhinolaryngology, 91577Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Suk Won Chang
- Department of Otorhinolaryngology, 91577Jeju National University School of Medicine, Jeju, Republic of Korea
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8
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Arredondo Montero J, Bronte Anaut M, López-Andrés N, Martín-Calvo N, Bardají Pascual C. A Tumor at the Base of the Tongue. J Pediatr 2022; 242:256-257. [PMID: 34752809 DOI: 10.1016/j.jpeds.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 11/01/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Affiliation(s)
| | | | - Natalia López-Andrés
- Cardiovascular Translational Research, Navarrabiomed (Miguel Servet Foundation), Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, Pamplona, Navarra, Spain
| | - Nerea Martín-Calvo
- Department of Preventive Medicine and Public Health, University of Navarra Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBERobn), Health Institute Carlos III, Madrid, Spain
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Tongue Osseous Choristoma in an 11-Year-Old Female: A Case Report and Literature Review Focusing on Pediatric Cases. Case Rep Dent 2021; 2021:8021362. [PMID: 34691790 PMCID: PMC8528635 DOI: 10.1155/2021/8021362] [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: 05/12/2021] [Revised: 09/02/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022] Open
Abstract
Osseous choristoma is an uncommon benign lesion characterized by the presence of ectopic mature bone within soft tissue. In most cases, these lesions occur on the dorsum of the tongue in patients in their third and fourth decades of life. This article describes a case of lingual osseous choristoma in a pediatric patient. An eleven-year-old girl with a lingual mass was referred to our hospital from a dental clinic. Total excisional biopsy and histological examination were performed, and osseous choristoma was diagnosed. The postoperative course was uneventful with no signs of recurrence during the 12 months after surgery. Moreover, a literature review focusing on pediatric cases with lingual osseous choristoma was performed to know the etiology, clinicopathological characteristics, and course of treatment of the lesion.
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Yun CB, Kim YM, Choi JS, Kim JW. Pediatric schwannoma of the tongue: A case report and review of literature. World J Clin Cases 2021; 9:7212-7217. [PMID: 34540980 PMCID: PMC8409190 DOI: 10.12998/wjcc.v9.i24.7212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 06/02/2021] [Accepted: 07/16/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Neurogenic tumors account for about ten percent of all tumors of childhood, and benign tumor originating from Schwann cells is rare in peripheral nerves. Schwannoma of the tongue is quite rare in children.
CASE SUMMARY We present the case of an 8-year-old male with schwannoma in the anterolateral tongue. The mass was slow-growing for one year with no pain and discomfort. He underwent transoral mass excision under general anesthesia. Gross examination revealed a smooth surfaced, 17 mm × 14 mm × 7 mm sized, encapsulated nodule with a clear resection margin. Schwannoma of the tongue was confirmed by the pathological exam. He reported no motor or sensory change, such as dysgeusia or paresthesia, or phonation difficulty during postoperative 12 mo follow-up.
CONCLUSION Schwannoma of the tongue is a rare benign neoplasm in childhood. If a painless firm mass is encountered in the tongue of a child, solid tumors like schwannoma should be considered in the differential diagnosis.
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Affiliation(s)
- Chang Bin Yun
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon 22212, South Korea
| | - Young-Mo Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon 22212, South Korea
| | - Jeong-Seok Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon 22212, South Korea
| | - Ji Won Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Inha University College of Medicine, Incheon 22212, South Korea
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11
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César CPHAR, Torres GMX, Andrade NS, Vanderlei KMHDO, Nascimento KMDS, Barroso BGIS, Santos EDS. Assessment of the tongue frenulum in Beckwith-Wiedemann syndrome: Pre- and post-frenectomy findings. SPECIAL CARE IN DENTISTRY 2021; 41:526-531. [PMID: 33964176 DOI: 10.1111/scd.12600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 03/04/2021] [Accepted: 03/07/2021] [Indexed: 11/29/2022]
Abstract
AIM To report the pre- and post-frenectomy findings of a patient with Beckwith-Wiedemann syndrome. METHODS AND RESULTS Clinical case report of a patient with a confirmed genetic-molecular diagnosis of the referred syndrome. The minor was evaluated and reassessed by the protocol for the evaluation of the tongue's frenulum for babies in two moments: pre-surgical and 2 months after the frenectomy. The surgical procedure was performed using the traditional technique and, after the procedure, the minor was breastfed and received photobiomodulation with a red laser. The minor obtained 16 points in the neonatal tongue screening test, indicating the need for a frenectomy. Thus, she was referred to a dentist for surgery. After the surgical procedure, macroglossia was observed as a maternal complaint (previously not mentioned). The wound healing was satisfactory, and the total score obtained in the reapplication of the protocol (five points) showed functional results of improvements in sucking and tongue mobility, justifying the importance of the frenectomy. CONCLUSION Frenectomy, despite showing macroglossia related to the Beckwith-Wiedemann syndrome, allowed anatomical and functional advances of the tongue in the present clinical case.
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Affiliation(s)
| | - Geciane Maria Xavier Torres
- Department of Speech Therapy, Federal University of Sergipe, Avenida Gov. Marcelo Déda, no number, Bairro São José, Lagarto, Sergipe, 49400-000, Brazil
| | - Natália Silva Andrade
- Department of Dentistry, Federal University of Sergipe, Avenida Gov. Marcelo Déda, no number, Bairro São José, Lagarto, Sergipe, 49400-000, Brazil
| | | | - Karla Monique de Souza Nascimento
- Departament of Speech Therapy, Federal University of Sergipe, Avenida Gov. Marcelo Déda, no number, Bairro São José, Lagarto, Sergipe, 49400-000, Brazil
| | - Brenna Geovania Izaura Santos Barroso
- Departament of Speech Therapy, Federal University of Sergipe, Avenida Gov. Marcelo Déda, no number, Bairro São José, Lagarto, Sergipe, 49400-000, Brazil
| | - Emerson de Santana Santos
- Department of Medicine, Federal University of Sergipe, Avenida Gov. Marcelo Déda, no number, Bairro São José, Lagarto, Sergipe, 49400-000, Brazil
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Pediatric Tongue Lesions: An Often-Overlooked but Important Collection of Diagnoses. AJR Am J Roentgenol 2020; 214:1008-1018. [DOI: 10.2214/ajr.19.22121] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Dursun A, Kastamonı Y, Kacaroglu D, Yuzbasıoglu N, Ertekın T. Morphometric development of the tongue in fetal cadavers. Surg Radiol Anat 2019; 42:3-8. [PMID: 31401676 DOI: 10.1007/s00276-019-02301-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 08/03/2019] [Indexed: 12/26/2022]
Abstract
PURPOSE The tongue is a specific organ for the sense of taste. It consists of the striated muscle and mucous membrane. Furthermore, it helps the functions of speech, chewing, and swallowing. In this study, we aimed to reveal some morphometric properties of the tongue in fetal cadavers. METHODS The study was conducted on a total of 45 fetal tongues (25 male tongues, 20 female tongues) aged between 17 and 40 weeks. The fetuses were divided into three groups as trimester II, trimester III, and full term. For each tongue, the length, width, area, free tongue length, and the terminal sulcus angle were measured using Image J program. The free tongue length/tongue length ratio was examined. RESULTS The obtained data were compared according to the trimester groups and genders. It was determined that the tongue length, width, area, and free tongue length increased during the trimesters and that there was no significant difference in the terminal sulcus angle and the free tongue length/tongue length ratio between the trimesters. No significant difference was found in all parameters between the genders. CONCLUSIONS This study presented significant data on morphometric development of the tongue. These data are thought to be useful for determining the anomaly and variations of the tongue.
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Affiliation(s)
- Ahmet Dursun
- Department of Anatomy, Faculty of Medicine, Suleyman Demirel University, 32260, Isparta, Turkey.
| | - Yadigar Kastamonı
- Department of Anatomy, Faculty of Medicine, Suleyman Demirel University, 32260, Isparta, Turkey
| | - Demet Kacaroglu
- Department of Medical Biology, Faculty of Medicine, Suleyman Demirel University, 32260, Isparta, Turkey
| | - Neslihan Yuzbasıoglu
- Department of Anatomy, Faculty of Medicine, Istanbul Medipol University, 34815, Istanbul, Turkey
| | - Tolga Ertekın
- Department of Anatomy, Faculty of Medicine, Afyonkarahisar Health Sciences University, 03200, Afyonkarahisar, Turkey
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Naples J, Martin A, Sobelman D, Schoem S. Unusual Fungal Lesion Presenting as a Neoplastic Pediatric Tongue Mass. Pediatrics 2017; 139:peds.2016-1345. [PMID: 28557716 DOI: 10.1542/peds.2016-1345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 11/24/2022] Open
Abstract
Tongue lesions in the pediatric population are rare. The differential diagnosis of these lesions is broad, and rapid growth of the lesion is concerning for a neoplastic process. We present a rare case of a fungal lesion mimicking a neoplastic growth in a 22-month-old girl. She underwent complete excision successfully. Full evaluation for benign and malignant neoplasms was negative. Tissue culture demonstrated growth of a rare Candida species to be the cause of the lesion. Postoperatively, she continues to do well, without regrowth 6 months later. This case reinforces the role of tissue culture when histology fails to demonstrate a diagnosis and emphasizes the need for efficient communication between the pediatrician, otolaryngologist, and pathologist for timely excision.
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Affiliation(s)
- James Naples
- Department of Otolaryngology, University of Connecticut Health Center, Farmington, Connecticut;
| | - Alison Martin
- Quinnipiac University School of Nursing, Hamden, Connecticut; and
| | - Debora Sobelman
- Saint Francis Hospital and Medical Center, Department of Pediatrics, and
| | - Scott Schoem
- Connecticut Children's Medical Center, Department of Otolaryngology, University of Connecticut School of Medicine, Hartford, Connecticut
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15
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Al-Saraf A, Yassan L, Cipriani NA, Agrawal N, Chang P, Ginat DT. Desmoid-Type Fibromatosis of the Tongue. Head Neck Pathol 2016; 10:527-529. [PMID: 27091208 PMCID: PMC5082041 DOI: 10.1007/s12105-016-0716-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
Abstract
Desmoid-type fibromatosis rarely occurs in the oral tongue. Diagnostic imaging, including ultrasound, is useful for delineating the extent of the lesion and can aid in treatment planning. However, definitive diagnosis is made based on the characteristic histologic features, which include cytologically bland spindle cells with surrounding collagenous matrix and minimal mitotic activity. Immunohistochemical analysis of these lesions reveals that they are classically positive, at least focally, for smooth muscle actin, calponin and muscle-specific actin. These features are exemplified in this sine qua non radiology-pathology correlation article.
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Affiliation(s)
- Ali Al-Saraf
- Department of Radiology, The University of Chicago, Chicago, IL USA
| | - Lindsay Yassan
- Department of Pathology, The University of Chicago, Chicago, IL USA
| | | | - Nishant Agrawal
- Department of Otolaryngology, The University of Chicago, Chicago, IL USA
| | - Paul Chang
- Department of Radiology, The University of Chicago, Chicago, IL USA
| | - Daniel T. Ginat
- Department of Radiology, The University of Chicago, Chicago, IL USA ,University of Chicago Medicine, 5841 S Maryland Ave, Chicago, IL 60637 USA
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16
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Singh PM, Rajeshwari S, Borle A, Rangasamy V. Sevoflurane-Based General Anesthesia Induction via Nasopharyngeal Endotracheal Tube Prior to Definitive Airway Control in Pediatric Oral Tumors. Anesth Prog 2015; 62:118-21. [PMID: 26398129 DOI: 10.2344/12-00037r1.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Airway-related tumors in pediatrics are always challenging for anesthesiologists. We present 2 cases of friable, bleeding large tumors in the oral cavity where conventional methods of securing the airway were not possible. Induction of general anesthesia could potentially lead to complete airway collapse and catastrophic obstruction in such cases. Awake fibrotic intubation is limited in pediatric patients. We describe the innovative use of an endotracheal tube inserted blindly as a nasopharyngeal airway guided by end-tidal carbon dioxide trace. This allowed us to bypass the anatomical obstruction and induce anesthesia using sevoflurane in high-flow oxygen. By the described technique, we were able to maintain and assist the spontaneous breathing of the child as well. We also highlight limitations of the use of a conventional nasopharyngeal airway in such situations.
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Affiliation(s)
| | | | - Anuradha Borle
- Senior Resident, Department of Anesthesia, All India Institute of Medical Sciences, New Delhi, India
| | - Valluvan Rangasamy
- Senior Resident, Department of Anesthesia, All India Institute of Medical Sciences, New Delhi, India
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Osseous choristoma of the tongue: a review of etiopathogenesis. Case Rep Otolaryngol 2014; 2014:373104. [PMID: 25580337 PMCID: PMC4279709 DOI: 10.1155/2014/373104] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 10/30/2014] [Indexed: 11/17/2022] Open
Abstract
Osseous choristoma is a normal bone tissue in an ectopic position. In the oral region lingual localization occurs more frequently and the mass is generally localized on the dorsum of the tongue.
Definitive diagnosis is obtained only after histopathologic examination. The etiology remains already debatable. The treatment of choice is surgical excision. In this paper we present a case of tongue osseous choristoma and a review of the literature.
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Alaeddini M, Barghammadi R, Eshghyar N, Etemad-Moghadam S. An analysis of biopsy-proven tongue lesions among 8,105 dental outpatients. J Contemp Dent Pract 2014; 15:1-7. [PMID: 24939256 DOI: 10.5005/jp-journals-10024-1478] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM The aim of the present study was to analyze data on the characteristics of tongue lesions in dental patients seeking care at the Oral Pathology Service of Tehran University of Medical Sciences, from 1985-2010. MATERIALS AND METHODS Demographic data and histopathologic diagnoses were recorded for all lesions that were documented as occurring on the tongue according to the patient records in our department. Statistical analysis included chi-square, t-, and Fisher's exact tests. A 95% confidence interval (CI) was calculated, and p < 0.05 was considered significant. RESULTS Tongue lesions constituted 6.3% of all received specimens which included 46 different defects. The most common lesions were lichen planus (LP), irritation fibroma (IF), squamous cell carcinoma (SCC) and pemphigus vulgaris (PV). Tongue lesions were significantly more common in women compared to men (CI = 0.65-0.94, p = 0.02). Mean age (47 years) did not differ between male and female subjects (CI = -2.49 - 3.93, p = 0.06). The dorsal surface followed by the lateral aspect was the most common site for tongue lesions. CONCLUSION It seems that dental practitioners should be perceptive of LP, IF, SCC and PV, when examining the tongue. Histopathologic analysis is essential for achieving final diagnosis in a considerable number of lesions that commonly occur on this organ. Clinical significance: Access to demographic/prevalence data in different populations may be useful in clinical settings and could be complimented by histopathologic diagnosis in most instances. The present findings can be compared with those obtained from other epidemiologic studies in this field resulting in valuable data which may be used in several types of investigations. .
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Affiliation(s)
- Mojgan Alaeddini
- Assistant Professor, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Roohollah Barghammadi
- Dentist, Department of Oral and Maxillofacial Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Nosratollah Eshghyar
- Associate Professor, Department of Oral and Maxillofacial Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahroo Etemad-Moghadam
- Assistant Professor, Dental Research Center, Tehran University of Medical Sciences, Tehran, Iran
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An analysis of the epidemiological and etiological factors of oral tumors of young adults in a Central-Eastern European population. Pathol Oncol Res 2013; 19:353-63. [PMID: 23645516 DOI: 10.1007/s12253-013-9628-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 03/18/2013] [Indexed: 01/27/2023]
Abstract
The etiology of tumors in young age is not precisely known yet, but studies on the topic generally agree that in this group of patients the traditionally known behavioural risk factors (tobacco and alcohol abuse) play no or a significantly less important role. Oral squamous cell carcinoma occurring at a young age is a topic of utmost importance that is extensively and intensively researched as, while the overall incidence of oral cancer is decreasing worldwide, that of squamous cell carcinoma diagnosed in young adults is steadily increasing. The present article aims at presenting the main questions and characteristics of tumors in young adults in Central-Eastern Europe and in developed West European countries as contrasted to tumors found in middle aged and elderly patients. Factors influencing the development of oral cancer include regulatory factors of the cell cycle, the inherited vulnerability of the genetic code of certain proteins and the presence of HPV infection with an oncogenic genotype. The connections of HPV infection and genetic damages are studied intensively. It is known that the prevalence of oral HPV infections is growing with a background of potentially changing sexual habits. It is debated, however, whether smoking and alcohol consumption could have a connection to HPV associated oral cancer and whether the spread of HPV in itself could be an explanation for the growing occurrence of young-age tumors. There is no consensus in the literature as to the prognostic significance of age. Some research groups have found a better life expectancy for young patients, while other authors found a worse prognosis for these patients. It is known that the prognosis of head and neck tumors, the prevalence of HPV infections as well as genetic mutations show regional and ethnic variations. This might be explained by differences in the degree of development of a preventive system, in the quality of care and in the attitudes of young patients towards visiting a doctor. The study is made difficult by incomparable patient selection criteria as well as by the question of the intraoral localisation of tumors as an independent risk factor.
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20
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Tani M, Hirota K, Habara T, Fukuda K. Successful perioperative airway management in a patient with angiomatous macroglossia for laser ablation under general anesthesia. J Anesth 2013; 27:789-90. [PMID: 23619724 DOI: 10.1007/s00540-013-1616-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 04/10/2013] [Indexed: 11/25/2022]
Affiliation(s)
- Midori Tani
- Department of Anesthesia, Kyoto University Hospital, 54 Shogoin-Kawaracho, Sakyo-Ku, Kyoto, 606-8507, Japan
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22
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Allon I, Allon DM, Hirshberg A, Shlomi B, Lifschitz-Mercer B, Kaplan I. Oral neurovascular hamartoma: a lesion searching for a name. J Oral Pathol Med 2011; 41:348-53. [DOI: 10.1111/j.1600-0714.2011.01101.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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23
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Yacovone L, Roberson D, Ng MW. Riga-Fede disease: a rare sublingual traumatic ulcerative lesion in a child. Otolaryngol Head Neck Surg 2011; 146:333-4. [PMID: 21690272 DOI: 10.1177/0194599811413220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Laura Yacovone
- Department of Otolaryngology and Communication Enhancement, Children's Hospital Boston, Boston, Massachusetts, USA
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25
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Pontes HAR, Pontes FSC, Cruz e Silva BT, Martel LPG, Carneiro JT, Silva BSDF, Pinto DDS. Angiomyolipomatous hamartoma of the upper lip: a rare case in an 8-month-old child and differential diagnosis. J Craniomaxillofac Surg 2010; 39:102-6. [PMID: 21067937 DOI: 10.1016/j.jcms.2010.10.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 07/16/2010] [Accepted: 10/04/2010] [Indexed: 11/25/2022] Open
Abstract
Hamartoma is a proliferation of normal tissues that are considered endogenous to the site of occurrence. In the head and neck region, hamartomas composed of other tissues different from blood and lymphatic vessels (hemangiomas and lymphangiomas) are very uncommon. We report an unusual case of upper lip angiomyolipomatous hamartoma in an 8-month-old patient. The patient underwent surgical treatment and the 1-year follow-up revealed no signs of recurrence. Angiomyolipomatous hamartoma is a very rare condition in the paediatric population group, especially in the head and neck region. It should be considered in the differential diagnosis of congenital lesions in childhood.
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26
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Cohen A, Maly A, Shteyer A, Zeltser R. Intrauterine diagnosis of teratoid cyst with bronchogenic epithelium. J Oral Maxillofac Surg 2010; 69:214-7. [PMID: 20598417 DOI: 10.1016/j.joms.2009.12.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 11/21/2009] [Accepted: 12/26/2009] [Indexed: 10/19/2022]
Affiliation(s)
- Adir Cohen
- Department of Oral and Maxillofacial Surgery, Hebrew University, Hadassah, Israel.
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27
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Nagy A, Barabás J, Vannai A, Németh Z, Bogdán S. Report of a rare case of tongue cancer in childhood. Orv Hetil 2010; 151:462-4. [DOI: 10.1556/oh.2010.28829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Malignus nyelvtumor előfordulása gyermekkorban meglehetősen ritka entitásnak számít. A nyelven előforduló különböző elváltozások differenciáldiagnosztikája során ebben a korcsoportban gyakran fel sem merül mint potenciális lehetőség. Így az adekvát kezelés és sebészi megoldás csak jelentős késéssel történik meg, ami a beteg sorsát megpecsételheti. A szerzők egy 15 éves gyereknél kialakult nyelvkarcinóma esetét ismertetik, valamint ennek kapcsán rövid irodalmi áttekintést adnak, hogy felhívják a figyelmet a gyermekkori malignus nyelvtumor diagnosztikájának fontosságára.
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Affiliation(s)
- Attila Nagy
- 1 Veszprém Megyei Csolnoky Ferenc Kórház Nonprofit Zrt. Arc-, Állcsont- és Szájsebészeti Osztály Veszprém
| | - József Barabás
- 2 Semmelweis Egyetem, Fogorvos-tudományi Kar Arc-, Állcsont-, Szájsebészeti és Fogászati Klinika Budapest Mária u. 52. 1085
| | - Anett Vannai
- 2 Semmelweis Egyetem, Fogorvos-tudományi Kar Arc-, Állcsont-, Szájsebészeti és Fogászati Klinika Budapest Mária u. 52. 1085
| | - Zsolt Németh
- 2 Semmelweis Egyetem, Fogorvos-tudományi Kar Arc-, Állcsont-, Szájsebészeti és Fogászati Klinika Budapest Mária u. 52. 1085
| | - Sándor Bogdán
- 2 Semmelweis Egyetem, Fogorvos-tudományi Kar Arc-, Állcsont-, Szájsebészeti és Fogászati Klinika Budapest Mária u. 52. 1085
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29
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Heterotopic neuroglial tissue: two cases involving the tongue and the buccal region. ACTA ACUST UNITED AC 2008; 105:e22-9. [DOI: 10.1016/j.tripleo.2008.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Revised: 01/30/2008] [Accepted: 02/10/2008] [Indexed: 12/19/2022]
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30
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Fan SQ, Ou YM, Liang QC. Glial choristoma of the tongue: report of a case and review of the literature. Pediatr Surg Int 2008; 24:515-9. [PMID: 17972083 DOI: 10.1007/s00383-007-2061-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2007] [Indexed: 11/26/2022]
Abstract
Glial choristoma of the tongue is an extremely rare developmental malformation. The authors report a case of a 5-month-old male baby with a congenital glial choristoma located on the posterior part of midline of the left dorsal tongue. Histological examination of the resected specimen revealed a poorly demarcated submucosal mass containing neuroglial tissue, scattered neuron, choroids plexus and ependyma. In addition to neuroglial tissue, a sheet of leptomeningeal tissue was observed more rarely in the case. The clinical and pathological characteristics of previous cases and their probable embryogenesis were also reviewed.
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Affiliation(s)
- Song-Qing Fan
- Department of Pathology, Second Xiang Ya Hospital of Central South University, Changsha, Hunan 410011, China.
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31
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Kreiger PA, Ernst LM, Elden LM, Kazahaya K, Alawi F, Russo PA. Hamartomatous Tongue Lesions in Children. Am J Surg Pathol 2007; 31:1186-90. [PMID: 17667541 DOI: 10.1097/pas.0b013e3180674dd7] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The incidence and spectrum of tongue lesions in children, in particular tongue hamartomas, is relatively unknown. We report a retrospective review of all tongue lesions seen at a major tertiary care children's hospital over an 18-year period with an emphasis on describing tongue hamartomas. A total of 135 tongue lesions were identified. Vascular/lymphatic lesions (36/135) were the most common followed by mucus extravasation phenomenon (22/135). Interestingly, hamartomatous lesions (18/135) were the third most common lesion category identified. Lingual hamartomas were predominantly submucosal in location and were classified histologically by tissue composition as follows: neurovascular (2/18), smooth muscle predominant (5/18), fat predominant (1/18), and smooth muscle and fat containing (10/18). All 5 smooth muscle predominant hamartomas also contained vasculature, and 1 case additionally contained salivary gland tissue. The single fat predominant hamartoma additionally contained vessels and salivary gland. The final 10 hamartomas contained varying amounts of both smooth muscle and fat, and also admixed combinations of vessels, nerves, and salivary glands. Two of these 10 cases additionally contained foci of choristomatous elements, including cutaneous adnexal structures and cartilage. Most patients with hamartomatous lesions were young, 2 years or less. Eight cases were congenital in origin. Females outnumbered males by 2:1. The majority of lesions (16/18) were dorsal in location, and 4 patients had a syndromic association, all oral-facial-digital syndrome.
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Affiliation(s)
- Portia A Kreiger
- Department of Pathology, The Children's Hospital of Philadelphia and University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA.
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32
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Demirseren ME, Aydin NE. A lingual osteoid mass originating from hyaline cartilage. J Craniomaxillofac Surg 2007; 35:132-4. [PMID: 17449260 DOI: 10.1016/j.jcms.2006.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2006] [Accepted: 12/07/2006] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Lingual osseous and chondromatous growths are rare but well-defined entities. The cause of these growths is still unknown, but several theories have been proposed. CASE PRESENTATION A mass measuring one cm in diameter on the dorsum of the tongue in a 28-year-old male causing discomfort was found to consist predominantly of hyaline cartilage with prominent bone transformation. CONCLUSION This finding confirms that bony masses in the tongue may originate from cartilaginous precursors, in contrast to similar masses seen on the face which are (often) purely osseous.
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Affiliation(s)
- M Erol Demirseren
- Department of Plastic, Reconstructive and Aesthetic Surgery, Ataturk Training and Research Hospital, Bilkent, Ankara, Turkey.
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33
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Celik M, Akkaya H, Arda IS, Hiçsönmez A. Congenital teratoma of the tongue: a case report and review of the literature. J Pediatr Surg 2006; 41:e25-8. [PMID: 17101342 DOI: 10.1016/j.jpedsurg.2006.08.039] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Teratomas of the head and neck are rare. They develop in neonates and are associated with feeding difficulty, airway obstruction, and difficulty in swallowing (which may cause polyhydramnios). Although some tumors consist of immature elements, teratomas of the head and neck are mature in nature, and excision is the most effective treatment. We present a case report of a neonate with a polypoid mass protruding from his mouth. He exhibited respiratory arrest immediately after birth and underwent intubation. The mass, which was completely excised, was histologically identified as a mature teratoma.
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Affiliation(s)
- Mustafa Celik
- Department of Pediatric Surgery, Baskent University Faculty of Medicine, 06490 Bahçelievler Ankara, Turkey
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34
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Chiang YC, Shih JC, Peng SSS, Hsu WC, Lee CN. Tongue teratoma--a rare form of fetal extragonadal teratoma diagnosed at 30 weeks' gestation. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2006; 28:737-41. [PMID: 16969784 DOI: 10.1002/uog.3824] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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35
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Harmouch A, Sefiani S, Oujilal A, Elmjareb C, Kamouni M, Maher M, Saidi A. [Tumor of the tongue in a child]. Ann Pathol 2006; 26:139-41. [PMID: 16791129 DOI: 10.1016/s0242-6498(06)70696-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Amal Harmouch
- Service d'Anatomie Pathologique, Hôpital des spécialités, CHU Ibn Sina, Rabat, Maroc.
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36
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Ameh EA, Mshelbwala PM, Rafindadi AH, Farindadi AH. Lingual harmatoma in an infant. ANNALS OF TROPICAL PAEDIATRICS 2006; 26:137-9. [PMID: 16709333 DOI: 10.1179/146532806x90655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Lingual tumours are uncommon in infants and harmatomas are rarely reported. A 5-month-old boy presented with a growth on the dorsum of the tongue which had been present from birth. The growth produced no respiratory or feeding difficulties. It was confirmed to be a harmatoma after complete excision. There has been no recurrence.
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Affiliation(s)
- E A Ameh
- Division of Paediatric Surgery, Department of Surgery, Ahmadu Bello University Teaching Hospital, Zaria, Nigeria.
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Takamizawa S, Inoue T, Ono Y, Satoh S, Nishijima E, Muraji T, Tsugawa C. A case report of glial choristoma of the tongue. J Pediatr Surg 2006; 41:e13-5. [PMID: 16567162 DOI: 10.1016/j.jpedsurg.2006.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Glial choristoma of the tongue is extremely rare. The authors report the case of a 9-day-old infant with a congenital lingual glial choristoma. Complete surgical excision was performed without postoperative complications or recurrence. The authors also present a review of the literature and outcome of this benign tumor.
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Abstract
Tumors of the tongue and the base of mouth are seen rarely in children. The incidence of the ones that are large enough to fill the oral cavity is especially low. If not recognized and treated, tongue tumors may obstruct the upper aero-digestive tract and be fatal. A case of a huge lingual cystic tumor mimicking ranula, and obstructing the upper aero-digestive tract, which was diagnosed antenatal and treated during and after the delivery, is presented together with a review of the literature.
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Affiliation(s)
- M Umut Akyol
- Department of Otorhinolaryngology, Section of Pediatric Otorhinolaryngology, Hacettepe University Medical School, Ankara, 06100, Turkey.
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Abstract
The seminal work of Mulliken and Glowacki in 1982 elucidated the histological differences between hemangiomas and vascular malformations: the former are characterized by endothelial cell proliferation, whereas the latter contain mature endothelial cells. Hemangiomas proliferate and then involute, whereas malformations remain stable in size, growing proportionally with the child. Vascular malformations are classified by the predominant vessel type within the lesion (capillary, venous, arterial, and lymphatic). Histological classification therefore correlates with clinical behavior. Treatment of hemangiomas is generally conservative; however, intervention may be required as a result of cosmetically concerning, function-threatening (e.g., interference with eyesight), or life-threatening (e.g., airway obstruction) lesions. Options include steroid therapy, laser treatment, and/or surgical excision. Vascular malformations do not involute and are more likely to require treatment. Treatment options include embolization and surgical resection. Understanding the clinical course of pediatric vascular lesions allows the surgeon to find an appropriate balance between watchful observation, providing reassurance when appropriate, and intervention when needed.
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Affiliation(s)
- John A Van Aalst
- Indiana University Medical Center, Riley Children's Hospital, Indianapolis, Indiana 46202-5200, USA
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Abstract
A 4-year-old girl presented with hypernasal speech. On examination, in addition to velopharyngeal incompetence noted by speech examination, a palatal tumor was found in between the cleft palate. The computed tomographic and magnetic resonance imaging examinations were suspicious for midline teratoma. Total excision of the nasopalatal tumor was performed, and the pathology revealed benign teratoma. After 6 months of follow-up, no recurrence was noted. A two-flap palatoplasty with a superior-based pharyngeal flap was then performed to reconstruct the palatal defect and to correct the velopharyngeal incompetence. An anterior oronasal fistula developed after the operation, but a tongue flap was transferred to cover the defect successfully. The purpose of this case report is to present the relationship between a congenital midline nasopalatal tumor and cleft palate.
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Affiliation(s)
- Chi-Cheng Liang
- Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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