Kurt J. Knowles
Louisiana State University, USA.
Title: Oral foregut duplication cysts: A rare and fascinating congenital lesion Case report
Biography
Biography: Kurt J. Knowles
Abstract
Oral foregut duplication cysts are extremely rare lesions with approximately 57 cases reported. They are congenital cysts, located in the anterior or ventral tongue, and occur predominantly in males. They are lined by one or more types of epithelia which is limited to gastric, intestinal or respiratory epithelium. The differential diagnosis includes lymphangioma, hemangioma, ranula, epidermoid cyst, teratoma and less likely a malignant process. They are congenital and if present at birth or early infancy, and they can cause difficulties in feeding, swallowing, speech, and airway obstruction. If discovered in utero and suspected to be large enough, they may also cause respiratory distress and optimal patient care would dictate that ENT be present at delivery. Even a small lesion if left untreated may cause speech difficulties in toddlers so definitive treatment is required.
What is fascinating about oral foregut duplication cysts is the possible histogenesis. They are always comprised of one or more upper GI and/or respiratory tissues. This trapped primitive tissue, apparently removed from its normal milieu, still has the capability to differentiate into gastric, intestinal or respiratory tissue, singly or in combinations of epithelia as was this case. This suggests that the trapped cells are preprogrammed to differentiate along certain possible cell lines but are influenced by some unknown local or distant environmental factors.