Choristoma involving the floor of the mouth and the anterior tongue: a case of teratoid cyst with gastric and respiratory epithelia

Choristoma: A rare congenital tumor of the tongue

Most congenital masses of the mouth floor are cystic, irrespective of their origin. They may obstruct airway or digestive tract or may present other complications. Recognizing and treating these masses expeditiously is imperative. Choristoma is a mass of normal tissue in an abnormal location; they are classified according to the predominant epithelial lining. Few cases have been reported lined with gastric and respiratory epithelia within the same cyst. This case report presents a 5-month-old boy with an infected choristoma involving the floor of the mouth and its successful management.

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.

Congenital huge submandibular and neck teratoid cyst in newborn

Head and neck teratoid cysts are the least common congenital cysts in the head and neck region, accounting for approximately 1.8% of all dermoid cysts. Teratoid cysts exhibiting mesodermal elements may be lined by gastric, intestinal, respiratory, squamous, or cilitated epithelium. We present a case of huge submandibular and neck teratoid cyst in newborn with airway obstruction and feeding difficulty. Surgical extirpation is the treatment of choice. However, before operation, some other cystic diseases in the head and neck region needs to be excluded. Fine-needle aspiration biopsy was necessary in differential diagnosis of lesions before treatment, especially that the principle of treatment of those diseases is different.