Indian Journal of Surgery Medknow Publications on behalf of Association of Surgeons of India ISSN: 0972-2068 Vol. 65, Num. 5, 2003, pp. 435-436

Indian Journal of Surgery, Vol. 65, No. 5, Sept-Oct, 2003, pp. 435-436

Case Report

Chondroma of the tongue

Deepak Kumar Sinha, Jeevan Lal Sahni,* Asha Agarawal**

Department of Cardio-thoracic & Vascular surgery, St. John's Medical College & Hospital, Bangalore, India; *Department of Cardio-thoracic & Vascular surgery, L.P.S. Institute of Cardiology, Kanpur, G.S.V.M. Medical College, Kanpur, India and **Department of Pathology, G.S.V.M. Medical College, Kanpur, India.
Address for correspondence Dr. Deepak Kumar Sinha, #2, 5th Cross Ex-servicemen Colony, Dinnur Main Road, R.T. Nagar, Bangalore 560032. E-mail: deepakksinha@yahoo.com

Paper Received: June 2002. Paper Accepted: October 2002. Source of Support: Nil

How to cite this article: Sinha DK, Sahni JL, Agarawal A. Chondroma of the tongue. Indian J Surg 2003;65:435-6.

Code Number: is03087

ABSTRACT

The occurrence of chondroma in the soft tissue of the oral cavity is uncommon. This anomaly occurs mainly on the lateral side or dorsum of the tongue. Here we report a case of a well-defined cartilaginous tumour of the tongue in a 10-year-old boy, diagnosed histologically as a chondroma. The swelling was present on the dorsal aspect of the right half of the tongue at the junction of its posterior 1/3 and anterior 2/3. The swelling was removed successfully in toto and the patient made an uneventful recovery.

Key Words: Tongue, Chondroma.

INTRODUCTION

Chondroma is a benign neoplasm derived from mesodermal cells that form cartilage. Chondromas are commonly seen in short tubular bones and flat bones. Rarely, they may arise in soft tissue as a hamartomas, but their occurrence in the tongue is extremely rare.^1,2

CASE REPORT

A 10-year-old boy presented with a slowly growing swelling over the tongue of 8 years duration. He did not complain of any pain in the swelling. Examination revealed a smooth, firm, non-tender, and slightly mobile swelling measuring 2.5 X 2 cm on the right half of the tongue at the junction of its posterior 1/3 and anterior 2/3. There was no cervical or submental lymph node enlargement. At surgery the swelling could be removed in toto with ease via a longitudinal incision over the tongue. Gross examination of the excised swelling revealed a globular, well-encapsulated greyish brown, mass with greyish white cut surface (Figure 1). Microscopy showed a well-encapsulated tumour with lobules of mature hyaline cartilage, having several well-formed chondrocytes embedded in the myxo-hyaline matrix. Many of the chondrocytes had a single nucleus. No mitosis was observed (Figure 2). Based on these findings a histopathological diagnosis of chondroma of the tongue was made. The patient was discharged the day after surgery and remains well a year later.

DISCUSSION

Chondromas are benign tumours of bone, characterised by proliferating mature chondrocyte lying in a hyaline myxoid matrix. Various terms such as chondroma, cartilaginous choristoma, osteocartilaginous choristoma, osteochondroma and chondroma with ossification or calcification have been used by different authors to refer to tumours of the tongue with similar histological findings. In tongue these tumours probably arise as a result of cartilaginous differentiation of undifferentiated mesenchymal cells.

The theories of origin of this glossal lesion relate to either ectopic embryonic rests of pleuripotent mesenchyme or post-traumatic mesenchyme metaplasia.^3,4 These lesions are usually located in the middle third of the dorsum of the tongue⁵ but they have also been reported in the buccal mucosa, soft palate⁶ and in the neck associated with a branchial cleft cyst.⁷ It has been stated that chondromas which occur at the antero-lateral region of the tongue may be traumatic in origin since this site is more vulnerable to trauma.¹

Cartilaginous rests are the origin of lingual chondroma on the dorsum of the tongue.⁸ Immunohistochemistry confirmed the lesion to be mesenchymal and not epithelial in origin. In the differential diagnosis it is important to exclude chondromatous change in a pleomorphic adenoma and also the possibility of a metastasis from an osseous chondrosarcoma. In our patients the tumour presented well-formed lobules of hyaline cartilage containing proliferating mature chondrocytes. As in our patient, the tumour can usually be successfully removed in toto without leaving behind any residual disease. Carbon dioxide laser facilitates the excision, providing a dry surgical field. It is important to bear in mind this rare tumour when presented with a swelling in the tongue and treat it adequately by surgical removal.

REFERENCES

1. Bhagwan J, Rajgopalan MR. Osteochondroma of the tongue. Indian J Pathol Micobiol 1976;19;135-8.
2. Landini G, Kitano M, Urago A, Sugihara K, Yamashita S. Chondroma and Osteochondroma of the tongue. Oral Surg Oral Med Oral Pathol 1989;68:206-9.
3. Roy JJ, Klein HZ, Tipton DL. Osteochondroma of the tongue. Arch Path 1970;89:565-8.
4. Munro JM, Singh MP. Chondroma of tongue. Arch Pathol Lab Med 1990;114:541-2.
5. Mosqueda-Taylor A, Gonzalez-Guevara M, de la Piedra-Garza JM, Diaz-Franco MA, Toscano-Garcia I, Cruz-Leon A. Cartilaginous choristomas of the tongue: review of the literature and report of three cases. J Oral Pathol Med 1998;27:283-6.
6. Tosios K, Laskaris G, Eveson J, Scully C. Benign Cartilaginous tumor of the gingiva. A case report. Int J Oral Maxillofac Surg 1993;22:231-3.
7. Koa CH, Wang HW, Yu CD. Cartilaginous choristoma of the neck associated with a branchial cleft cyst. J Otolaryngol Head Neck Surg 2001;124:705-6.
8. Ysauoka T, Handa Y, Watanabe F, Oka N. Chondroma of the tongue. Report of a case. J Maxillofac Surg 1984;12:188-91.

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