Case Report: Synchronous lingual osseous choristoma and suprahyoid thyroglossal duct cyst: insights into the embryological thyroglossal-hyoid axis.

Lingual osseous choristoma is an exceedingly rare benign lesion characterized by the presence of mature bone tissue within the soft tissue of the tongue, where osseous structures are not normally found. Thyroglossal duct cysts (TGDCs) are common congenital midline neck lesions resulting from incomplete involution of the thyroglossal duct during embryogenesis. Both entities share a common embryological pathway extending from the tongue base through the hyoid bone to the lower cervical region. However, the synchronous occurrence of a lingual osseous choristoma and a suprahyoid TGDC in a single patient has rarely been reported. A 26-year-old woman presented with a slowly enlarging posterior tongue mass and a persistent foreign-body sensation during swallowing. Intraoral examination revealed a firm, pedunculated lesion covered by intact mucosa at the midline posterior tongue near the circumvallate papillae. Contrast-enhanced cervical magnetic resonance imaging incidentally demonstrated a well-circumscribed cystic lesion posterior to the hyoid bone, suggestive of a suprahyoid TGDC. Under general anesthesia, the lingual mass was excised via an endoscope-assisted intraoral approach, followed by transcervical excision of the TGDC with partial segmental resection of the hyoid bone and