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

Mixed Heterotopic Gastrointestinal/Respiratory Oral Cysts in Newborns: From Prenatal Diagnosis to Histopathological and Therapeutic Management: A Case Report and Literature Review

Fetal lingual tumors are very rare, and their early prenatal diagnosis is important for defining the subsequent therapeutic strategy. In this study, we aimed to describe a case of a congenital septate lingual cyst and perform an extensive literature review on two main databases (PubMed, Web of Science), analyzing the clinical manifestations, the imaging appearance, the differential diagnosis, and particularities regarding the treatment of these tumors. The electronic search revealed 17 articles with 18 cases of mixed heterotopic gastrointestinal/respiratory oral epithelial cysts that met the eligibility criteria and were included in this review. The clinical case was diagnosed prenatally during second-trimester screening. On the eighth day of life, the fetus underwent an MRI of the head, which revealed an expansive cystic process on the ventral side of the tongue with the greatest diameter of 21.7 mm, containing a septum of 1 mm inside. On the 13th day of life, surgery was performed under general anesthesia, and the lingual cystic formation was completely excised. The postoperative evolution was favorable. The histopathological examination revealed a heterotopic gastric/respiratory-mixed epithelial cyst with non-keratinized respiratory, gastric squamous, and foveolar epithelium. The lingual cyst diagnosed prenatally is an accidental discovery, the differential diagnosis of which can include several pathologies with different degrees of severity but with a generally good prognosis.

Enteric duplication cyst of the tongue in a newborn: A case report and literature review

Enteric duplication cysts (EDCs) are congenital anomalies. We report the case of a 5-day-old girl with a 2.0 cm congenital oral mass in the tongue, an extremely uncommon site of EDC. The tongue mass was resected without complication; microscopic findings were characteristic of an EDC, and the patient is doing very well. The English literature was researched for the cases of single congenital oral cavity masses diagnosed prenatally or at birth as EDC or EDC-like lesions. Cystic lesions of the oral cavity partially lined by gastrointestinal epithelium, without teratoma features, have received several names. Similarities between EDC and EDC-like lesions favor the idea of one lesion with several morphologies manifest along a spectrum and that the necessity for EDC diagnosis of the smooth muscle coat criteria could be re-evaluated to improve the categorization of these lesions and better understand the pathogenic mechanism.

A Bronchogenic Cyst Masquerading as a Tongue Mass

Bronchogenic cysts are foregut-derived developmental anomalies found along the developmental pathway of the foregut. The putative theory of pathogenesis is abnormal budding or branching of epithelial cells during the development of tracheobronchial tree. Over 99 % of cases occur in the mediastinum and lung while the head and neck area is affected in less than 1 % of cases with only rare cases reported in the oral cavity. This is a report of a case of a bronchogenic cyst arising in a 6-year-old male. The lesion presented as a painless swelling of the left underside of the tongue. Microscopically, the cyst was lined by pseudostratified columnar epithelium exhibiting many ciliated and mucous cells. A focus of cartilage and discontinuous bundles of smooth muscle were present adjacent to the lining. Where there was cyst rupture, there was granulation tissue associated with many foamy macrophages and acute and chronic inflammation. Four other cases, three in the tongue and one in the lower lip vestibule with cutaneous extension, all in the midline, have been reported in a 1 day-old male, 4 year-old male, 6 year-old female and 3 year-old male. There was no recurrence after excision and this is in keeping with the behavior in previous reports. Other developmental cysts including foregut cysts may be focally lined with respiratory epithelium but the presence of cartilage is the sine qua non for the diagnosis of a bronchogenic cyst.

Lingual cyst with respiratory epithelium: report of 2 cases and review of the literature

The lingual cyst with respiratory epithelium, a congenital cyst of the tongue or floor of the mouth, is lined predominately by respiratory-type epithelium. The terminology for this lesion was first proposed in 1999 by Manor et al., who stated that a descriptive term is best for this cyst of debatable pathogenesis. Although it is a cyst of foregut origin, the lingual cyst with respiratory epithelium is distinguished from the traditional enteric (foregut) duplication cyst in that the latter contains gastric and/or intestinal-type mucosa and has smooth muscle within the cyst wall. This article presents 2 new cases of this entity, as well as reviews the 19 cases that have been reported in the literature and were found to fulfill the histologic criteria of an lingual cyst with respiratory epithelium.