Odontogenic Choristoma in the Genian Subcutaneous Region of a Pediatric Patient: A Case Report

Abstract

Choristomas are rare, benign tumor-like proliferations characterized by the development of histologically normal tissues in ectopic anatomical locations. Odontogenic choristomas, in particular, are uncommon findings in the maxillofacial region, often misdiagnosed as other neoplasms or reactive lesions. Objectives: This paper aims to report and clinically analyze a rare case of odontogenic choristoma located in the subcutaneous region of the cheek in a pediatric patient, deepening the discussion on its etiopathogenesis. Methodology (Case Report): A 12-year-old male patient presented with a palpable, painless, hard nodule in the left cheek, associated with chronic biting habits. Imaging (ultrasound) revealed a subcutaneous calcified lesion. An excisional biopsy was performed via an extraoral approach. Results and Discussion: Histopathological analysis confirmed the presence of immature bone trabeculae and acellular eosinophilic material compatible with dentinoid, immersed in dense connective tissue, establishing the diagnosis of odontogenic choristoma. The hypothesis of tissue metaplasia induced by chronic microtrauma versus embryological failure is discussed, as well as the absence of Klippel-Feil Syndrome signs in this specific case. Conclusion: Odontogenic choristoma must be included in the differential diagnosis of calcified nodular lesions of the maxillofacial region, especially in areas prone to local trauma. Complete surgical excision proved to be both therapeutic and diagnostic, with an excellent prognosis and no signs of recurrence.