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BACKGROUND: An ocular osseous choristoma is a growth of mature, compact bone in the ocular or periocular soft tissue, and it is the rarest form of ocular choristoma, accounting for only 1.7% of all epibulbar choristomas. CASE PRESENTATION: Herein we present the case of a 20-month-old girl who was referred to the oculoplasty clinic with a progressively growing mass in the left lateral canthus. It had been present since birth without ocular involvement. Upon examination the mass was firm with a smooth surface, measured 9 × 6 × 3 mm, and exhibited no episcleral attachment or ocular involvement. An excisional biopsy was performed, and the histopathological findings were consistent with osseous choristoma of the left lateral canthus. CONCLUSIONS: This report highlights the importance of considering osseous choristoma in the differential diagnosis of eyelid lesions, particularly those that have been present since birth. It also emphasizes the need for further studies investigating associations between osseous choristomas and ocular canthi.
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Coristoma , Oftalmopatias , Aparelho Lacrimal , Feminino , Humanos , Lactente , Coristoma/diagnóstico , Coristoma/cirurgia , Coristoma/patologia , Aparelho Lacrimal/patologia , Oftalmopatias/cirurgia , Pálpebras/patologia , Osso e Ossos/patologiaRESUMO
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.
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Coristoma , Nevo Pigmentado , Nevo , Neoplasias Cutâneas , Pré-Escolar , Humanos , Coristoma/diagnóstico , Coristoma/cirurgia , Coristoma/patologia , Nevo Pigmentado/diagnóstico , Nevo Pigmentado/cirurgia , Nevo Pigmentado/patologia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/patologiaRESUMO
A healthy 18-year-old girl presented with a superotemporal epibulbar mass that was present since birth. Computed tomography revealed a cystic mass with fat-like low-density and a central oval-shaped mass that was isodense to the bone in the superotemporal region of the globe. Histopathology of the excised tumour revealed osseous choristoma and dermolipoma. Our review of literature yielded nine reported cases of epibulbar osseous choristoma within a dermolipoma and we reviewed these cases.
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Coristoma/patologia , Lipoma/patologia , Órbita , Neoplasias Cutâneas/patologia , Adolescente , Biópsia por Agulha , Coristoma/diagnóstico por imagem , Coristoma/cirurgia , Feminino , Seguimentos , Humanos , Lipoma/diagnóstico por imagem , Lipoma/cirurgia , Estudos Retrospectivos , Neoplasias Cutâneas/diagnóstico por imagem , Neoplasias Cutâneas/cirurgia , Tomografia Computadorizada por Raios X , Acuidade Visual/fisiologiaRESUMO
PURPOSE: To present the pre-, per- and postoperative features of epibulbar osseous choristoma. METHODS: Case description including intraoperative imaging and histopathology. RESULTS: A 32-year-old male patient presented with a lesion on his right eye, suggestive of an epibulbar dermolipoma. Excision of bony lesion was performed and revealed epibulbar osseous choristoma. CONCLUSIONS: Epibulbar osseous choristoma is a rare and benign condition which can present with features similar to dermolipoma.
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Osso e Ossos , Coristoma/diagnóstico , Doenças da Esclera/diagnóstico , Adulto , Coristoma/cirurgia , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Procedimentos Cirúrgicos Oftalmológicos , Doenças da Esclera/cirurgia , UltrassonografiaAssuntos
Calcinose , Coristoma , Oftalmopatias , Osso e Ossos , Coristoma/diagnóstico por imagem , Coristoma/cirurgia , HumanosRESUMO
Choristomas are proliferative growths that occur when normal tissue develops in abnormal locations and may resemble tumors. Oral choristomas commonly present as slow-growing, indolent, and firm masses. The diagnosis primarily relies on histopathologic examination. Given their tumor-like growth and developmental pathogenesis, it is critical to differentiate them from neoplasms. In this article, we present two clinical cases of oral choristomas, a cartilaginous choristoma, and an osseous choristoma of the tongue. We also offer a brief review of the literature discussing clinical presentation, microscopic features, and therapeutic options.
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Coristoma , Doenças da Língua , Humanos , Coristoma/diagnóstico , Coristoma/patologia , Doenças da Língua/diagnóstico , Doenças da Língua/patologia , Masculino , Feminino , Diagnóstico Diferencial , Adulto , Pessoa de Meia-Idade , Doenças da Boca/diagnóstico , Doenças da Boca/patologiaRESUMO
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.
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We report a case of a 40-year-old Japanese woman with a benign tongue tumor diagnosed as osseous choristoma of the tongue. Resection of the tongue tumor was performed under general anesthesia. The gross examination of the resected specimen showed a bone-like mass measuring 5 × 5 × 3 mm, surrounded by soft tissue. Based on the findings, a histopathological diagnosis of osseous choristoma was established. There was no evidence of tumor recurrence or distant metastasis during the 3-year follow-up.
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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.
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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.
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Osteoma , Doenças da Língua , Neoplasias da Língua , Humanos , Neoplasias da Língua/cirurgia , Neoplasias da Língua/patologia , Osteoma/cirurgia , Osteoma/patologia , Doenças da Língua/cirurgia , Língua/patologiaRESUMO
BACKGROUND: Choristoma is a rare, benign, congenital proliferative tumor, with osseous choristoma being the rarest. Although the tumor is benign, effective identification is needed for its diagnosis and treatment. Here, we report the diagnosis and successful surgical treatment of two patients with osseous choristoma. CASE SUMMARY: Two patients, a young female and young male patient, were found to have a mass on the ocular surface. The tumor presented on the superior temporal bulbar conjunctiva in the first patient and on the upper eyelid in the second patient. Ultrasound biomicroscopy detected a strong echo with clear boundaries covering the lower echo, and computed tomography examination revealed calcification. Both patients underwent surgery, and histopathological evaluation of the mass showed osseous choristoma. They were treated by excision and subsequently cured. CONCLUSION: Osseous choristomas are usually asymptomatic. Our patients were cured immediately after surgery, suggesting that surgical treatment is an effective strategy.
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We present the case of a 3-year-old male child with an epibulbar bone choristoma. The patient presented with a hard consistency subconjunctival mass of 8×10mm in the superior-temporal quadrant of his right eye along with vascularisation and a long cilium of approximately 8 to 10mm that touched the corneal surface. The histopathology study showed the presence of trabeculae of mature, compact bone surrounded by fibrous tissue, as well as Havers channels with concentric rings of laminar bone without bone marrow, and with normal osteocytes which defined the diagnosis of epibulbar bone choristoma. Osseous choristoma is the rarest type of the ocular choristoma and should be considered as a differential diagnosis among paediatric epibulbar tumours.
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Osso e Ossos , Coristoma , Doenças da Túnica Conjuntiva , Pré-Escolar , Coristoma/diagnóstico , Coristoma/cirurgia , Doenças da Túnica Conjuntiva/diagnóstico , Doenças da Túnica Conjuntiva/cirurgia , Humanos , MasculinoRESUMO
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.
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Osseous choristoma is a rare entity in the oral and maxillofacial region. The most common site is the tongue, followed by the buccal mucosa. Osseous choristoma of the muscle is unusual and few cases have been described in the literature. No reports have described osseous choristoma arising on the medial side of the lateral pterygoid muscle. Herein, we report the first such case. A 61-year-old woman was referred to our facility for treatment of temporomandibular joint disorder. Computed tomography (CT) revealed two osseous lesions on the medial side of the lateral pterygoid muscle. Preoperatively, a three-dimensional (3D) life-sized model of the skull was fabricated from the CT imaging data. The 3D skull model was used to clarify the 3D positional relationships of the osseous lesions relative to the surrounding anatomical structures. Surgery to remove the osseous lesions was performed under general anesthesia. Unfortunately, only the larger of the two masses was able to be resected because of the risk of nerve and vascular injury. Histological examination revealed that the resected lesion comprised mature lamellar bone with regular osteocytes and no atypia. The diagnosis was multiple osseous choristomas based on the histological and clinical findings.
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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.
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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.
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We present a case of a 15-year-old girl with an epibulbar osseous choristoma. The patient presented with a 3×3 mm, whitish, firm subconjunctival mass in the superotemporal quadrant of her right eye with vascularization. She underwent excision biopsy of the mass under topical anesthesia. The pathologic sections were consistent with a well-circumscribed osseous tissue without atypia. Osseous choristoma is one of the rare types of ocular choristoma to be considered in the differential diagnosis of pediatric epibulbar tumors.
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PURPOSE: To present the case of a 12-year-old female with an epibulbar osseous choristoma. OBSERVATIONS: The patient presented with right-sided conjunctival mass, which caused her discomfort. Slit lamp examination revealed a 5×5-mm, firm nodule in the superotemporal quadrant of the bulbar conjunctiva. The nodule had feeder vessels, adhered firmly to the sclera, and lacked signs of malignancy. The patient underwent excisional biopsy under general anesthesia. During this procedure, great care was taken to avoid perforation of the globe. The pathologic sections were significant for well-circumscribed osseous tissue without atypia. CONCLUSIONS AND IMPORTANCE: We describe diagnosis and successful surgical management of osseous choristoma the rarest subtype of ocular choristoma. With only 65 cases reported since mid-19th century, the condition remains poorly described. This report provides additional information on diagnosis and treatment of this rare condition.
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BACKGROUND: Osseous choristoma is a very rare, benign lesion in the maxillofacial region. It appears as a benign mass of normally matured bony tissue covered by the normal epithelium of the tongue. It is usually seen in front of the foramen cecum of the tongue. Surgical excision is the treatment of choice with an excellent prognosis and there have been very few cases of recurrence. CASE PRESENTATION: Here we present two cases of osseous choristoma on the dorsum of the tongue. Case 1 was a 15-year-old Japanese girl who presented with a painless but gradually growing swelling on the dorsum of her tongue approximately 1 year before her admission. Case 2 was a 21-year-old Japanese woman with a complaint of pain in the lower left, posterior side of her mouth. Histological findings showed that both lesions were composed of well-organized, mature, compact bone beneath the oral mucosal membrane. Subsequent to simple surgical excision, no recurrence of the lesions was observed after the follow-up period. Previous literatures have proposed both malformation and trauma hypotheses as the etiopathologies of osseous choristoma. However, the histopathological findings of the two cases in the present study do not support the trauma hypothesis. CONCLUSIONS: Although osseous choristoma is clinically a benign condition, the underlying histopathological processes are important. The outcome of aberrant formation of calcified tissue in the vicinity of vital structures such as nerves and blood vessels may be of clinical significance.
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Osso e Ossos , Coristoma/patologia , Doenças da Língua/patologia , Língua/patologia , Adolescente , Adulto , Coristoma/complicações , Coristoma/cirurgia , Feminino , Humanos , Prognóstico , Doenças da Língua/complicações , Doenças da Língua/cirurgia , Resultado do TratamentoRESUMO
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.