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Dafne Fernandes Machado,1 Stela Souza Peña,1 Mariana Carneiro Alves,1 Giovana Capecci Siqueira,1 Leonardo Amarante Pereira,1 Samantha Sanches de Carvalho,2 Thais Moura Gascon,2 Beatriz da Costa Aguiar Alves,2 Glaucia Luciano da Veiga,1,2 Fernando Luiz Affonso Fonseca,1– 3 Vagner Loduca Lima,1 Priscilla Ballalai1 1Ophthalmology Discipline, Centro Universitário Saúde ABC/ Faculdade de Medicina Do ABC, Santo André, Brasil; 2Clinical Analysis Laboratory, Centro Universitário Saúde ABC/ Faculdade de Medicina Do ABC, Santo André, Brasil; 3Department of Pharmaceutical Sciences, Universidade Federal de São Paulo, Diadema, BrasilCorrespondence: Dafne Fernandes Machado, Ophthalmology Discipline, Centro Universitário Saúde ABC/ Faculdade de Medicina do ABC, Av. Lauro Gomes, 2.000, Santo André, São Paulo, 09060-870, Brasil, Tel +55-114993-5400, Email dafnefm13@gmail.comAbstract: Choroidal osteoma is a rare, benign, osseous choristoma presenting as an orange-yellow, well-defined fundus mass. It presents unilaterally in most cases, has a predilection for the female sex, and favor a juxtapapillary location, becoming clinically manifest when it involves the macula. Almost 60% of eyes with osteoma may suffer significant visual loss. Choroidal osteomas can easily be mistaken for other conditions with similar presentations. We herein report two rare cases presentation of choroidal osteoma: a 74-year-old male with 2-year blurred vision in the right eye (RE) initially misdiagnosed with age-related macular degeneration received intravitreal injections and after a multimodal evaluation, following cataract surgery in RE, confirmed to be choroidal osteoma and a 19-year-old female with a history of choroidal hemangioma presented with blurred vision in her left eye (LE), with examination revealed an irregular orange-yellow lesion along the superotemporal arcade with serous macular detachment, later diagnosed as choroidal osteoma.Keywords: choroidal osteoma, osseous choristoma, visual loss, case reports

Abstract Background An ocular osseous choristoma is a growth of mature, compact bone in the ocular or periocular soft tissue, and it is the rarest form of ocular choristoma, accounting for only 1.7% of all epibulbar choristomas. Case presentation Herein we present the case of a 20-month-old girl who was referred to the oculoplasty clinic with a progressively growing mass in the left lateral canthus. It had been present since birth without ocular involvement. Upon examination the mass was firm with a smooth surface, measured 9 × 6 × 3 mm, and exhibited no episcleral attachment or ocular involvement. An excisional biopsy was performed, and the histopathological findings were consistent with osseous choristoma of the left lateral canthus. Conclusions This report highlights the importance of considering osseous choristoma in the differential diagnosis of eyelid lesions, particularly those that have been present since birth. It also emphasizes the need for further studies investigating associations between osseous choristomas and ocular canthi.

Osseous choristoma is a tumor-like growth of lamellar bone which is found in a location where the bone does not normally form. It rarely occurs in the mandibular buccal vestibule. These lesions are either developmental (arising from ectopic mesenchymal cells) or a consequence of trauma and chronic irritation. A 50-year-old male was presented for diagnostic evaluation and surgical management of a long-standing hard mass involving the buccal vestibular sulcus of the mandible. The lesion was clinically examined and radiographically investigated using panoramic, intraoral, and cone-beam computed tomography images. Surgical excision was considered the ideal treatment, and postoperative histopathological examination confirmed a diagnosis of osseous choristoma. There was no evidence of recurrence over a 2-year follow-up period. Osseous choristoma involving the mandibular buccal vestibule can be misdiagnosed as an osteoma because of its clinical presentation; however, the lesion is typically not attached to the underlying bone and can be easily separated from the surrounding tissues. The diagnosis is based on clinical and radiographic examinations and generally confirmed by histopathological analyses.

Osseous choristoma of the eye is a rare entity with few case reports being published in the literature. We report one such case in a 14-year old female who had a small growth in the right eye present since birth, which gradually increased in size. Excision biopsy was done. Histologically, the mass was composed of mature bone with surrounding benign adipocytes.

Lingual osseous choristoma is an extremely rare condition, of which only 61 cases have been reported. Monserrat in 1913 was the first to report this bony lesion on the dorsum of the tongue and it was labelled as lingual osteoma, the term that normally describes neoplastic pathology. Krolls et al changed this term later to osseous choristoma, which means normal tissue in an abnormal location. The aetiology and pathogenesis of lingual osseous choristoma remain debatable. We report a case of lingual osseous choristoma and review the literature.