Objective:

To report a rare case of concurrent lingual osseous choristoma and suprahyoid thyroglossal duct cyst and explore their potential embryological connection.

Approach:

• Patient Presentation: A 26-year-old woman presented with a posterior tongue mass and foreign-body sensation during swallowing.
• Imaging and Diagnosis: Contrast-enhanced MRI revealed a cystic lesion suggestive of a suprahyoid TGDC, and histopathological examination confirmed the diagnoses.
• Surgical Management: The lingual mass was excised endoscopically, followed by transcervical excision of the TGDC and partial resection of the hyoid bone.

Key Findings:

• Lingual osseous choristoma is a rare benign lesion with mature bone tissue in the tongue.
• Thyroglossal duct cysts are common congenital neck lesions due to incomplete involution of the thyroglossal duct.

Interpretation:

The synchronous occurrence of these lesions may indicate a dual manifestation of residual mesenchymal tissue along the embryological axis.

Limitations:

• The rarity of concurrent occurrences limits broader generalizations.

Conclusion:

The findings highlight the importance of thorough imaging of the thyroglossal tract when encountering osseous lesions.