Lingual osteoma: A debatable entity

Purpose: This article analyzes osseous lesions in the tongue with regard to the clinical and histologic features and discusses the pathogenesis and terminology of these lesions. Materials and Methods: Thirty-eight cases of lingual osseous lesions were retrieved from the English language literature, and two new cases were added. Results: The lesions had a female predilection, with a female-to-male ratio of 2.3:1. Mean age of the patients at time of diagnosis was 31.4 years. The lesions were located in the posterior third of the dorsum of the tongue in 67.5% of the cases, in the lateral margins in 25%, and in the mid-third of the tongue in 7.5%. Size ranged from 0.5 to 5.0 cm. Duration of the lesions ranged from several months to 50 years. In eight cases, there was information that the lesions had increased in size. Histologically, the lesions appeared a well-circumscribed mass of vital bone under the surface epithelium. The two new cases, when examined by polarized light, showed a mixture of woven and mature bone. Conclusion: The osseous lesions of the tongue represent a heterogeneous group of lesions in which some may represent a developmental malformation, and others may be a reactive lesion after trauma or irritation. Some lesions behave as true neoplasms and others as choristomas. It is suggested that the descriptive term "osseous tumorlike lesion of the tongue" may be more appropriate for this group.