A case report of glial choristoma of the tongue

Glial choristoma of the tongue. Clinicopathological analysis of a case and pathogenetic insights

“…Glial choristoma, which is a choristoma composed by glial cells either in association or not with other normal brain tissue elements, is more commonly restricted to the craniofacial region where the tongue is rarely involved [2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29]. Even though different terms have been used to define the lesion, including glioma [3,4,16], glial/gliomatous teratoma [5,10], heterotopic brain, or neural/glial/neuroglial tissue [6,7,8,9,11,24,28], the term glial choristoma is more appropriate because the lesion is a developmental anomaly and not a neoplasm and produces a tumour-like tissue mass [1,2].…”

“…Even though different terms have been used to define the lesion, including glioma [3,4,16], glial/gliomatous teratoma [5,10], heterotopic brain, or neural/glial/neuroglial tissue [6,7,8,9,11,24,28], the term glial choristoma is more appropriate because the lesion is a developmental anomaly and not a neoplasm and produces a tumour-like tissue mass [1,2]. Surgical excision with free margins is curative and, because the lesion may be only suspected at clinical examination, histology and immunohistochemistry are mandatory for the definitive diagnosis [13,15,17,18,20,21,22,23,24,25,26,27,28,29,30].…”

“…The pathogenetic mechanism leading to the development of the glial choristoma in the craniofacial region is not known, and different pathogenetic theories have been suggested [1,5,11,13,16,17,18,19,21,23,25,26,27,28,30,31]. Of note, a potential role of the cells normally emanating from the cranial neural crests (CNCs), which are involved in the development of the ectomesenchymal components of the human head including the tongue and express neuroglial differentiation as a normal developmental pathway [32,33,34,35,36,37,38,39,40,41,42,43,44], has been virtually never taken into account [1,18,30,31].…”

Glial choristoma of the tongue: report of a case and review of the literature

“…Preoperative imaging cannot distinguish glial choristoma from the other lingual masses. The differential diagnosis for tumor of the tongue includes squamous cell carcinoma, congenital granular cell tumor, thyroglossal duct cyst, dermoid cyst, teratoma, cavernous hemangioma, hamartoma, rhabdomyosarcoma, neurofibroma, myofibromas and myofibromatosis [9,12,16,17]. All the other masses in the differential diagnosis lack glial tissue except for a teratoma, however, a teratoma is ruled out because of the absence of mesodermal or endodermal components in a glial choristoma [8,12].…”

“…Several hypotheses have been proposed to explain this phenomenon [1, 6-8, 12, 17]. However, differentiation of pleuripotential embryonic remnants or a nest of pluripotential cells that become separated before the complete fusion of the neural tube, and integrate with myoblasts, which migrate to the tongue, is the most likely explanation [17].…”