Gastrointestinal cyst of the tongue: A possible duplication cyst of foregut origin

Heterotopic gastrointestinal mucosa in the oral cavity of adults

Heterotopic gastrointestinal mucosa (HGM) is a rare entity observed in the head and neck region and occurs more frequently in male infants and children. The floor of the mouth and anterior aspects of the tongue are the most commonly affected sites. Histologically, HGM resembles gastric, intestinal or colonic mucosa with areas of squamous epithelium, which can be cystic or solid. In the current report, 2 cases of HGM affecting the oral mucosa in patients over 35 years of age are presented, and one of these cases presented 2 nodules in different locations. Both cases represented solid lesions instead of the more common cystic presentation showing gastric glandular-type tissue that was lined with pseudostratified columnar epithelium containing crypts and fundic glands. Immunohistochemical analysis revealed positive expression of cytokeratins 7, 8 and 18 and smooth muscle actin (SMA). In both cases, the final diagnosis was HGM, and conservative surgical excision was performed.

Lingual cyst lined by squamous epithelium

Lingual choristomas or foregut duplication cysts are infrequently reported congenital anomalies that typically present in the perinatal period, and can cause respiratory or feeding problems. These cysts are lined by epithelial cells characteristic of the upper aerodigestive tract. We describe two children who presented shortly after birth with lingual cysts lined with squamous epithelium and foci of respiratory epithelium. Unlike previously reported lingual choristomas, these cysts did not contain gastrointestinal epithelium. In both these cases, the lingual cysts were successfully excised via a transoral approach. This article will discuss the histological findings in these two cases, the differential diagnosis and attempt to classify these lesions in the context of existing terminology.

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.