Osseous choristoma of the tongue in a pediatric patient: a case report

Background: Osseous choristoma is a rare benign lesion characterized by mature, histologically normal bone in an ectopic soft-tissue location. The tongue is its most common intraoral site, yet fewer than 70 cases have been reported worldwide, and pediatric cases remain especially scarce. Case: We report a case in a 15-year-old female with a firm, pedunculated posterior tongue mass first noticed by the patient at age seven and later identified incidentally during a routine primary care examination. The lesion’s long-standing clinical course, together with the histopathology findings, supports an embryological rather than a traumatic origin. The mass was successfully managed with excisional biopsy under moderate oral conscious sedation in an outpatient pediatric dental setting, avoiding the need for general anesthesia, and the diagnosis was confirmed by histopathology. At 5-month follow-up, the patient remained asymptomatic with a well-healed tongue and no evidence of recurrence, documented photographically. Conclusion: This case adds to the limited pediatric literature on lingual osseous choristoma and reviews the available evidence on preoperative imaging and prior pediatric presentations, reinforcing that this rare entity can be safely diagnosed and definitively managed within pediatric dental practice.

Osseous choristoma; Tongue lesion; Osteoma; Pedunculated mass; Surgical excision

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