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Intralingual foregut duplication cyst in a newborn
Mohamed A el-Bitar1, Gregory Milmoe, Shimareet Kumar
1Department of Pediatric Otolaryngology-Head and Neck Surgery, Children's National Medical Center, George Washington University School of Medicine, Washington, D.C., USA. mb36@aub.edu.lb
Insights
This study details a rare intralingual foregut duplication cyst lined with gastric mucosa. High-resolution sonography proved effective for prenatal diagnosis and surgical planning in newborns.
Area of Science:
- Pediatric Surgery
- Developmental Biology
- Gastroenterology
Background:
- Congenital lingual cystic masses present diagnostic and management challenges.
- Intralingual foregut duplication cysts are exceptionally rare, with few documented cases.
- These cysts can manifest prenatally or postnatally, requiring careful evaluation.
Observation:
- This report describes the ninth documented case of an intralingual foregut duplication cyst.
- The cyst was found to be lined with gastric mucosa.
- The lesion was detected in a newborn, presenting as a lingual cystic mass.
Findings:
- High-resolution sonography is a valuable, non-invasive tool for evaluating lingual cystic masses in infants.
- Sonography effectively characterized the lesion as a nonvascular cystic mass and delineated its extent.
- Computed tomography (CT) and magnetic resonance imaging (MRI) may necessitate sedation, posing risks to newborns.
Implications:
- Accurate prenatal and postnatal diagnosis of lingual cystic masses is crucial for appropriate management.
- High-resolution sonography offers a preferred imaging modality for neonatal lingual masses over CT or MRI.
- Bipolar cautery is presented as a safe and effective surgical technique for excising such lesions.
Abstract:
Congenital lingual cystic masses are challenging entities that can be detected prenatally or discovered in various forms after birth. We report what we believe is only the ninth case of an intralingual foregut duplication cyst that was lined with gastric mucosa. The preoperative evaluation of lingual cystic masses in newborns can include palpation, high-resolution sonography, computed tomography (CT), or magnetic resonance imaging (MRI). However, CT and MRI can pose a risk to the infant because they require sedation in order to properly position the patient for imaging. In our patient, we found that high-resolution sonography was most useful in revealing the nature of the mass as a nonvascular cystic lesion and in delineating its extension. We excised this lesion via bipolar cautery, which we prefer to cold-knife or CO2 laser surgery.
