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Congenital Foregut Duplication Cysts of the Anterior Tongue
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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