Lingual hamartoma in a child: a case report

To the Editor:—There are few reports in the literature of lingual hamartoma in children. This lesion is a rare benign tumorlike overgrowth of the tongue that results in a disor- dered mixture of tissue normally found in this area. A recent review reported only 28 cases in the past 50 years. They are composed of the following tissue: fat, smooth and skeletal muscle, lymphoid, connective, acini of salivary glands, glial elements, epithelium, and sometimes blood vessels and nerves.1 They are most common in younger children, espe- cially 2 years or younger, with a female-to-male ratio of almost 2:1.1 They may occur in association with syndromes (such as oral-facial-digital syndrome) or as isolated lingual lesion.2 Our patient is a 2.3-year-old boy who presented a single pol- ypoid mass, measuring 1 cm in greatest dimension, localized on the posterior and midline dorsum of the tongue (Fig 1). The lesion was surgically excised with free margins. After a 4-month clinical follow-up, no recurrence was observed. Histological ex- amination showed a polypoid mass covered by squamous epi- thelium and lobuli variable in size and shape of mature adipose tissue in the contest of lamina propria. This lobuli were sepa- rated by strands of fibrous connective tissue. No cytological atypia, necrosis, or mitosis was observed (Fig 2). Until now, the lingual hamartoma treated was not asso- ciated with other congenital or noncongenital malforma- tion, and the patient does not show other signs or symp- toms that can lead to a syndrome, although he will be kept under control, to intercept early any abnormal events. As in our case, lingual hamartomas are often polypoid and occur as solitary lesions on the dorsum of the tongue, usually posterior and midline in the area of the foramen cecum.3 Most lesions described in literature are composed primarily of fat tissue,1 as in our case, and occur in young children,3 such as our patient, who is aged 2.3 years. The goal of routine oral examination is to recognize oral lesions that may be the first manifestation of systemic diseases.