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Debbie Eaton, MD; Kathleen Billings, MD; Charles Timmons, MD, PhD; Timothy Booth, MD; J. Michael J. Biavati, MD

Arch Otolaryngol Head Neck Surg. 2001;127:1484-1487.

Objective  To review our experience with foregut duplication cysts of the anterior tongue, an unusual and rarely encountered mass in this location.

Design  A retrospective review of patients with anterior tongue foregut duplication cysts identified between 1990 and 2000.

Setting  Academic, tertiary care children's medical center.

Patients  Six pediatric patients (5 boys and 1 girl) ranging in age from birth to 8 months at diagnosis.

Intervention  Three patients underwent preoperative magnetic resonance imaging (MRI). All 6 patients underwent excisional biopsy.

Main Outcome Measures  Clinical description of foregut duplication cysts, ability to make the diagnosis preoperatively, and recurrence rates.

Results  No patient presented with respiratory compromise, despite the large size of the anterior tongue masses (range, 1.5-2.4 cm). An MRI study was performed in 3 patients, all given a presumptive diagnosis of dermoid cyst based on the radiographic findings. No patient was diagnosed correctly prior to surgical excision. All patients underwent surgical excision, and the average time from birth to surgical excision was 11 months (range, 3 days to 3.7 years). Surgical pathologic findings were reported as a foregut duplication cyst (enterocystoma) in all patients, with 3 specimens containing foci of gastric mucosa. No recurrence has occurred at 1-month follow-up.

Conclusions  Foregut duplication cysts rarely present in the anterior tongue and are easily misdiagnosed preoperatively. An MRI study is helpful in preoperative planning, although all lesions were radiologically indistinguishable from dermoid cysts. These masses may be an underappreciated entity in the differential diagnosis of congenital anterior tongue masses.

From the Departments of Otolaryngology (Drs Eaton and Billings), Pathology (Dr Timmons), and Radiology (Dr Booth), Children's Medical Center, The University of Texas Southwestern Medical Center, and Pediatric ENT Associates (Dr Biavati), Dallas, Tex.

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