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Choristomatous polyps of the aural and pharyngeal regions: first simultaneous case
Payman Simoni1, Brian J Wiatrak, David R Kelly
1University of Alabama at Birmingham, Division of Otolaryngology - Head and Neck Surgery, 1501 Fifth Avenue South, Birmingham, AL 35233, USA.
Insights
This case report details a rare instance of a newborn female with both a pharyngeal teratoid polyp and a middle ear salivary gland choristoma. These congenital anomalies likely stem from branchial arch developmental errors.
Area of Science:
- Embryology
- Otolaryngology
- Pathology
Background:
- Choristomas are rare congenital malformations involving heterotopic tissue.
- Branchial arch anomalies can manifest in various head and neck structures.
- This report focuses on the embryological origins of these specific malformations.
Observation:
- A female infant presented with a posterior pharyngeal mass diagnosed as a hairy teratoid polyp shortly after birth.
- At 10 months, a salivary gland choristoma was identified in the left middle ear during a myringotomy procedure.
- This represents the first reported case of both conditions occurring simultaneously in the same patient.
Findings:
- Histopathological analysis confirmed the diagnoses of hairy teratoid polyp and salivary gland choristoma.
- Literature review indicates choristomas are more common in females.
- Middle ear choristomas predominantly affect the left side.
Implications:
- The simultaneous occurrence suggests a shared or related embryological etiology, possibly linked to first and second branchial arch development.
- Understanding these rare conditions aids in diagnosing and managing congenital head and neck masses.
- Further research into branchial arch development may elucidate the pathogenesis of these complex malformations.
Abstract:
The first known case of embryological development of a salivary gland choristoma of the middle ear and a hairy teratoid (choristomatous) mass of the pharynx arising in the same patient is reported. On the day after the patient, a female, was born, a posterior pharyngeal mass was discovered, resected, and diagnosed histopathologically as a hairy teratoid (choristomatous) polyp. At 10 months of age, the patient underwent myringotomy and tympanostomy tube placement, and another mass was found in the left middle ear. This mass was diagnosed as a salivary gland choristoma. Our review of the literature showed that, consistent with our case, choristomas are more prevalent in females, and those in the middle ear almost always occur on the left side. Both types of polyps are rare and are thought to be due to errors in development of the second and first branchial arches.
