Congenital choristomas of the oral cavity in children

Authors

  • Raymond L. Chai MD,

    1. Department of OtolaryngologyChildren's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennyslvania, U.S.A.
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  • John A. Ozolek MD,

    1. Department of Pathology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennyslvania U.S.A.
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  • Barton F. Branstetter MD,

    1. Departments of Radiology and Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A.
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  • Deepak K. Mehta MD,

    1. Department of OtolaryngologyChildren's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennyslvania, U.S.A.
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  • Jeffrey P. Simons MD

    Corresponding author
    1. Department of OtolaryngologyChildren's Hospital of Pittsburgh of UPMC, University of Pittsburgh School of Medicine, Pittsburgh, Pennyslvania, U.S.A.
    • Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh of UPMC, 4401 Penn Avenue, Faculty Pavilion 7th Floor, Pittsburgh, PA 15224
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  • Presented at the Combined Sections Meeting of the Triological Society, Scottsdale, Arizona, U.S.A., January 27–29, 2011.

    Winner of the 2011 Eastern Section John J. Conley, MD, Resident Research Award.

    The authors have no funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objectives/Hypothesis:

To review our institutional experience with oral cavity choristomas in children.

Study Design:

Retrospective case series and medical record review.

Methods:

Medical records including clinic notes, operative reports, radiologic studies, and pathology specimens were reviewed. All imaging studies and pathology material were reviewed by a head and neck radiologist and pediatric pathologist, respectively.

Results:

Sixteen patients (10 males and 6 females) with congenital oral cavity choristomas were identified. Mean age at diagnosis was 1.8 months. Location of the lesions included tongue (n = 9) and floor of mouth (n = 7). Preoperative imaging included magnetic resonance imaging (n = 6), computed tomography (n = 5), plain radiography (n = 1), and no imaging (n = 4). Radiographically, the lesions were consistently lobular with well-defined margins, but other imaging features often mimicked other masses that can arise in the tongue and floor of mouth. Symptoms were present in five of 16 patients and included difficulty feeding, swelling with upper respiratory infection, and partial airway obstruction. Complete surgical excision was performed in 15 of 16 patients; mean age at the time of surgery was 12.7 months. One patient underwent marsupialization. No complications were noted perioperatively. No recurrences of choristoma were seen. On histologic examination, the predominant component was cystic with cyst linings of respiratory epithelium (n = 5), gastric (foveolar) epithelium (n = 1), or both (n = 10).

Conclusions:

This study supports surgical excision as an effective intervention for children with oral cavity choristomas. Because the etiology of these cysts is unknown and diagnostic terminology is widely variable, we propose a more descriptive diagnosis based on the histology (i.e., lingual choristoma [or lingual developmental cyst] with respiratory epithelium or lingual choristoma [or lingual developmental cyst] with gastric epithelium).

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