Oropharyngeal cartilaginous choristoma: a systematic review of the literature with novel clinical insights

Abstract

Cartilaginous choristoma of the oropharynx is an exceptionally rare benign lesion characterised by the presence of mature hyaline cartilage in an anatomical location where cartilage is not normally found, and its clinical, radiological, and histopathological characteristics remain poorly defined because of its rarity. We systematically reviewed all reported cases of oropharyngeal cartilaginous choristoma in the English-language literature and present a novel case of cartilaginous choristoma arising from the lateral pharyngeal wall. A systematic review was conducted according to the PRISMA 2020 guidelines by searching PubMed/MEDLINE, Scopus, Web of Science, Embase, and Google Scholar from database inception to June 2026. All studies reporting cartilaginous choristomas of the oropharynx were included, and descriptive statistical analysis was performed. Eighteen studies met the inclusion criteria, comprising 28 discrete lesions. The palatine tonsil was the predominant site (85.7%). The mean patient age was 28.6 years (range, 4-50 years), with a male-to-female ratio of 1.2:1. Recurrent tonsillitis was the most common presenting symptom (64.3%), while prospective studies reported an incidence of 3–6% among routine tonsillectomy specimens. Histopathological examination consistently demonstrated mature hyaline cartilage without atypia. Complete surgical excision was curative in all reported cases, with no documented recurrences. These findings indicate that oropharyngeal cartilaginous choristoma most commonly presents incidentally in tonsillectomy specimens or as a mass, producing obstructive symptoms, and that complete surgical excision, including the perichondrium, is curative. Although rare, this entity should be considered in the differential diagnosis of oropharyngeal masses to ensure accurate diagnosis and appropriate management.