Lingual Foregut Duplication Cyst - A Diagnostic and Therapeutic Challenge

Cystic developmental malformations of the oral cavity are exceedingly rare. These lesions may be identified prenatally through imaging or become apparent after birth. Clinically, these lesions manifest as a midline oral mass, often associated with feeding difficulties, airway obstruction, or failure to thrive. A 16-day-old male neonate was brought by his parents with a progressively enlarging swelling on the ventral surface of the tongue. Initially small, it soon led to poor feeding and episodes of respiratory distress, causing significant parental anxiety. Magnetic resonance imaging was suggestive of a lymphangioma. Surgical excision was performed. Histopathological examination showed cyst wall lined by respiratory pseudostratified ciliated epithelium and gastric foveolar epithelium, consistent with a foregut duplication cyst. Postoperative recovery was smooth, and the infant was able to feed comfortably. Child was followed up every 6 months and no recurrence was noted. Foregut duplication cyst involving the tongue, though rare, should be considered in the differential diagnosis of neonatal oral masses, given their potential for airway compromise.