Searching beyond nevi - A rare case of neurocutaneous ocular syndrome

Epidermal nevus syndrome is a rare congenital disorder affecting only a few hundred people in the world. It has ophthalmic, dermatological, and neurological manifestations, with varied presentation. Here, we report a case of two-year-old child who presented with epibulbar mass in left eye, pigmented nevi over left side of the body and alopecia over left side of parieto-temporal scalp. Imaging confirmed epibulbar mass and presence of calcification of choroid on ipsilateral side with presence of arachnoid cyst of brain with underlying pachygyria. Neurological examination was normal and dermatologist confirmed presence of verrucous nevi over skin. Excisional biopsy of epibulbar mass revealed a complex choristoma with presence of lacrimal gland tissue. Underlying ocular findings were near normal with normal posterior segment. It is a rare form of epidermal nevus syndrome with near normal ocular findings in the presence of anterior and posterior choristoma, which has not been reported.

Bilateral Tessier no. 7 cleft with an accessory maxilla and osseous choristoma: a case report

Tessier no. 7 clefts are characterized by macrostomia, facial muscular diastasis and maxillary and zygomatic bone abnormalities. It is caused by a lack of ectomesenchyme formation or penetration of the maxillary and mandibular processes during the fourth and fifth weeks of development. A case of bilateral transverse facial cleft with an accessory maxilla and an osseous choristoma is presented. The diagnosis of accessory maxilla was based on clinical findings due to the inaccessibility of orthopantomography and computed tomography scan. Orbicularis oris muscle reconstruction, cheiloplasty and excision of accessory maxilla were done. Histopathological examination of the bony lesion showed an osseous choristoma. There were no postoperative complications or local recurrence of the lesion excised. This case report demonstrates the importance of early diagnosis and intervention in maxillofacial congenital anomalies. Cheiloplasty restores function and gives the patient a natural appearance. The excision of accessory bone prevents further complications in the child's growth.

Tongue Osseous Choristoma in an Adolescent Female: A Case Report

Lingual osseous choristoma is a rare, benign, bony tumor without clear pathogenesis. Most patients present with an asymptomatic lump in the posterior tongue, while others may suffer from globus sensation, dysphagia, gagging, or irritation. Here, we present a case of lingual osseous choristoma in a pediatric patient managed with surgical excision.

Lingual Osteoma-A Case Report and Literature Review

Osteomas are rare benign bony tumors located in the tongue area. In most cases, patients presenting with a lingual osteoma are asymptomatic but may complain of the sensation of having a foreign body. Fewer than 100 cases of lingual osteoma have been reported worldwide. Here, we present 2 cases of tongue base osteoma that were treated with excision under a laryngoscope.

Lingual Osseous Choristoma: A Comprehensive Systematic Review of Lesion Presentation, Histology, and Morphology

INTRODUCTION

Osseous choristomas of the tongue are rare, benign tumor-like lesions composed of abnormally placed bone and cartilage tissue. The few publications to date concerning this condition have been primarily limited to case reports. This systematic review aimed to clarify the clinical presentations of osseous choristomas and how to delineate them from other oral pathologies.

METHODS

The authors utilized PubMed, Embase, and Cochrane Library reference databases from 1971 to mid-2020. Search terms were "osseous choristoma," "oral cavity," and "lingual." Preferred Reporting Systems for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to aggregate relevant data from each study. The authors specifically collected data regarding patient demographics, clinical findings, symptoms, treatments, and subsequent outcomes relating to lingual osseous choristomas.

RESULTS

A total of 35 (14.6% of total identified) publications that met inclusion criteria were identified concerning a total of 69 lingual osseous choristoma cases. Results were compiled focusing on sex and age, presenting symptoms, histology, appearance of the lesion base being most commonly pedunculated (e.g., stalk or stem-like), the lesion's location on the tongue, and subsequent treatments. Osseous choristomas had a higher rate of occurrence in females, 48 (70%) and those under the age of 40. Symptomatic presentations occurred in 38 (55%) patients, with the most common presenting symptoms being gagging/globus (i.e., lump or foreign body) sensation (n = 47, 68%) and dysphagia (n = 20, 29%). Identified masses were pedunculated in 33 (80%) of cases and eight (20%) were identified as sessile (i.e., immobile). A total of 41 (59%) lesions were more commonly located in the posterior one third of the tongue compared to 28 (41%) in the anterior two thirds of the tongue. Of those 49 (71%) cases requiring surgical mass excisions, recurrence was reported in 0% of cases.

CONCLUSIONS

Although osseous choristomas are benign processes that rarely arise from the tongue, providers should carefully inspect patients with a gagging/globus sensation and pedunculated mass toward the back of the tongue. Surgical resection remains the best treatment to prevent recurrence.

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

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.

Osseous choristoma of submental region: A rare occurrence

Osseous choristoma is a rare, benign lesion of the oral cavity. This report presents a case of osseous choristoma in the submental region of a 30-year-old female subject. Her chief complaint was a painless swelling in the submental region. Panoramic radiography showed a well-defined, round, radiopaque lesion near the inferior border of the left mental region. The lesion was diagnosed as an osseous choristoma based on the histopathological examination of the surgical specimen. This paper is an attempt to bring forward a unique occurrence of osseous choristoma, which would further help the medical fraternity in improvising their knowledge, diagnosis, and treatment of this entity.

Osseous choristoma of the labial mucosa: A rare case report

Osseous choristoma is a normal bone tissue in an ectopic position. These are slow growing lesions that are usually completely asymptomatic and only present when there is a disruption in the function of the organ due to its large size as it grows. Definitive diagnosis is obtained only after the histopathological examination. The etiology remains still questionable. The treatment of choice is surgical excision. Here we report a case of choristoma in the lower labial mucosa in a 47-year-old female.