An enteric duplication cyst occurring in the anterior two-thirds of the tongue

Mucosal Soft Tissue Lesions

Mucosal soft tissue lesions are fairly common in the pediatric population. However, the precise prevalence is unknown. This is the result of the limited number of studies, the use of various diagnostic criteria in those studies, and the transient nature of commonly encountered lesions in this population. In this section, we seek to familiarize the pediatric pathologist with a sampling of mucosal soft tissue lesions encountered in pediatric patients, highlight key diagnostic features and correlations with systemic diseases should they exist.

Histopathologic Finding of Both Gastric and Respiratory Epithelia in a Lingual Foregut Cyst

Foregut cysts are uncommon, mucosa-lined congenital lesions that may occur anywhere along the gastrointestinal or respiratory tract and typically present within the first year of life. Although infrequent, these cysts may generate feeding or respiratory difficulties depending on the size and location of the lesion. Foregut cysts of the oral cavity are rarely seen and of those cases localized to the tongue are even more uncommon. We describe a 4-month-old girl with a foregut cyst involving the floor of mouth and anterior tongue. Subsequent histologic analysis demonstrated a cyst lined with both gastric and respiratory epithelia. This case represents an extremely rare finding of both gastric and respiratory epithelia lined within a single cystic structure in the tongue. Although a very rare finding, a foregut cyst should be on the differential diagnosis of any lesion involving the floor of mouth or tongue in an infant or child.

Enteric duplication cyst located at the posterior tongue: a rare case report and review of the literature

The lingual localization of an enteric duplication is extremely rare but may present with respiratory and feeding problems that require emergency intervention. A 7-month-old boy was brought to our clinic with feeding difficulties and tongue swelling. Physical examination showed a cystic lesion located near the left side of the tongue base that caused tongue protrusion to the contralateral side. During surgery, a 3-cm diameter opaque thick-walled cyst was found to be very closely adherent to the base of tongue, which was excised in its entirety. Following surgery, the patient fed during the early postoperative period and no complications were observed other than hypersalivation. On histological examination, a cystic lesion lined with intestinal mucosa and goblet cells was found. We present the rare case of a duplication cyst of the posterior tongue, with a literature review.

Duplication cyst with esophageal mucosa at the floor of the mouth: a case report

Intraoral localization of alimentary tract duplication is extremely rare. We report a duplication cyst at the floor of the mouth, lined by esophageal epithelium and treated successfully by surgical excision. To our knowledge, this is the third case of intraoral enteric duplication cysts lined with esophageal epithelium reported in the literature.

Foregut duplication cyst presenting as lingual swelling: Case report and review of literature

Congenital lingual cystic masses are challenging entities that can be detected prenatally or are discovered in various forms after birth. Foregut duplication cyst of tongue is an extremely rare condition. Here we present the eleventh case in literature on foregut duplication cyst in tongue lined with gastric mucosa. Complete excision was curative with no recurrence on followup.

Anesthetic management of a neonatal lingual gastric duplication cyst: report of a rare case

Gastrointestinal duplications can occur anywhere from the mouth to the anal cavity. The occurrence of a duplication cyst in the tongue of a neonate is very rare. These cysts occur due to endodermal cells that are trapped during development. Congenital lingual cystic masses are challenging entities. They usually present in the neonatal period and surgical excision is curative. We report a 10-day-old, 3-kg neonate with a gastric duplication cyst in the oral cavity with inability to close his mouth or breast feed for whom we performed subtotal excision of the cyst.

Congenital choristomas of the oral cavity in children

OBJECTIVES/HYPOTHESIS

To review our institutional experience with oral cavity choristomas in children.

STUDY DESIGN

Retrospective case series and medical record review.

METHODS

Medical records including clinic notes, operative reports, radiologic studies, and pathology specimens were reviewed. All imaging studies and pathology material were reviewed by a head and neck radiologist and pediatric pathologist, respectively.

RESULTS

Sixteen patients (10 males and 6 females) with congenital oral cavity choristomas were identified. Mean age at diagnosis was 1.8 months. Location of the lesions included tongue (n = 9) and floor of mouth (n = 7). Preoperative imaging included magnetic resonance imaging (n = 6), computed tomography (n = 5), plain radiography (n = 1), and no imaging (n = 4). Radiographically, the lesions were consistently lobular with well-defined margins, but other imaging features often mimicked other masses that can arise in the tongue and floor of mouth. Symptoms were present in five of 16 patients and included difficulty feeding, swelling with upper respiratory infection, and partial airway obstruction. Complete surgical excision was performed in 15 of 16 patients; mean age at the time of surgery was 12.7 months. One patient underwent marsupialization. No complications were noted perioperatively. No recurrences of choristoma were seen. On histologic examination, the predominant component was cystic with cyst linings of respiratory epithelium (n = 5), gastric (foveolar) epithelium (n = 1), or both (n = 10).

CONCLUSIONS

This study supports surgical excision as an effective intervention for children with oral cavity choristomas. Because the etiology of these cysts is unknown and diagnostic terminology is widely variable, we propose a more descriptive diagnosis based on the histology (i.e., lingual choristoma [or lingual developmental cyst] with respiratory epithelium or lingual choristoma [or lingual developmental cyst] with gastric epithelium).

Magnetic resonance imaging findings of a foregut duplication cyst of the floor of the mouth in a fetus

The MRI findings are described in a case of foregut duplication cyst arising from the floor of the mouth in a fetus.

Foregut duplication cyst arising in the floor of mouth

Enteric duplications are uncommon. A rare foregut duplication cyst arising in the floor of mouth is reported. Diagnosis of cystic lesion within the oral cavity was made in utero. Enteric duplications have not yet been attributed to a single embryogenesis but are likely to represent an error in migration of normal cells that rest in an abnormal position. Immediately following delivery of the neonate via an ex-utero intrapartum treatment (EXIT) procedure, the cyst was marsupialised but required definitive surgical excision at 5 weeks of age.

Intralingual Foregut Duplication Cyst in a Newborn

Congenital lingual cystic masses are challenging entities that can be detected prenatally or discovered in various forms after birth. We report what we believe is only the ninth case of an intralingual foregut duplication cyst that was lined with gastric mucosa. The preoperative evaluation of lingual cystic masses in newborns can include palpation, high-resolution sonography, computed tomography (CT), or magnetic resonance imaging (MRI). However, CT and MRI can pose a risk to the infant because they require sedation in order to properly position the patient for imaging. In our patient, we found that high-resolution sonography was most useful in revealing the nature of the mass as a nonvascular cystic lesion and in delineating its extension. We excised this lesion via bipolar cautery, which we prefer to cold-knife or CO2 laser surgery.

Gastric choristoma of the hypopharynx presenting in an infant: a case report and review of the literature

Normal gastric mucosa has been found throughout the alimentary tract, ranging from scattered rests of cells to well formed mucosa with submucosal smooth muscle. Many terms have been applied to these collections; however, the term gastric choristoma seems most appropriate. We present a case of hypopharyngeal gastric choristoma presenting with dysphagia and frequent emesis. Our literature review reveals that this is the seventh reported case of gastric choristoma found in the hypopharynx, and the first to present in an infant in the absence of respiratory distress. Excision or CO(2) laser ablation is useful for symptom relief; however, complete removal often requires multiple attempts.

Heterotopic oral gastrointestinal cyst: report of 2 cases and review of the literature

Oral heterotopic gastrointestinal cyst is a rare entity occurring in infants and children and showing a predilection for males. The cyst usually appears as an asymptomatic swelling in the floor of the mouth. Difficulty in feeding, swallowing, respiration, and speech have been reported in approximately 30% of those affected. The tongue-in particular, its anterior aspectis involved in up to 60% of reported cases. The clinical, radiographic, and histopathologic features of cases of heterotopic gastrointestinal cyst involving the anterior tongue in a 2-year-old girl and the anterior floor of the mouth in a 2-month-old boy are presented, and theories of pathogenesis are discussed.

Lingual cyst with respiratory epithelium: an entity of debatable histogenesis

PURPOSE

The purpose of this report was to describe a new case of lingual cyst with respiratory epithelium, to review and analyze the literature regarding lingual cyst of foregut origin and lingual alimentary cyst, and to discuss the suitable terminology for these uncommon cysts.

MATERIAL AND METHODS

Data from articles published in the English language between the years 1942 and 1947 were used.

RESULTS

The review of the literature showed 53 lingual cysts of which 29 could be grouped into lingual alimentary tract cysts and 24 into lingual cysts of foregut origin. There was an overlap in histologic and clinical features and embryogenesis of both cysts.

CONCLUSIONS

Differentiation between both cysts cannot be supported, and until further information is accumulated it is suggested that histologic descriptive terms be used such as lingual cyst with respiratory epithelium, lingual cyst with gastric epithelium, or lingual cyst with respiratory and gastric epithelium.

Gastric cyst of the oral cavity

A case of a heterotopic gastric cyst of the oral cavity is described and a review of the literature, with emphasis on the possible etiological theories of this rare lesion, is presented. This developmental lesion is found more commonly in males. It most likely arises from misplaced embryonal tissue. Surgical treatment is the preferred choice of treatment, and CO2 laser is a safe alternative surgical approach for the removal of this lesion.