Oral foregut duplication cysts: A rare and fascinating congenital lesion; Case report and review of the literature
Kurt J Knowles
Louisiana State University Health Science Center, USA
: J Otol Rhinol
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 are 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.
Biography
Kurt J Knowles completed his Pathology Residency from 1991-1996 then cytopathology fellowship from 1996-1997. He was in private practice from 1997 to 2015 and recently transitioned from 18 years in private practice in pathology to the medical center practice of pathology at Louisiana State Health Science Center in Shreveport LA. His responsibilities include teaching medical students and pathology residents, and pathology to internal medicine residents. His subspecialty sign-out responsibilities include cytopathology, gastrointestinal pathology and head and neck pathology. The faculty at LSU is engaged in numerous research activities covering many areas of clinical and academic medicine. The article presented at this meeting combines gastroenterology pathology; head and neck pathology with implications for developmental pediatrics, OB-Gyn, anesthesia and embryology.
