Published online Sep 6, 2020. doi: 10.12998/wjcc.v8.i17.3808
Peer-review started: May 26, 2020
First decision: July 25, 2020
Revised: August 1, 2020
Accepted: August 20, 2020
Article in press: August 20, 2020
Published online: September 6, 2020
Processing time: 100 Days and 20.5 Hours
Heterotopic gastrointestinal cysts have gastrointestinal epithelium in the cyst wall and rarely occur in the oral cavity. Most are found in the neonatal period. However, heterotopic gastrointestinal cysts that are diagnosed as a congenital tongue cyst by routine ultrasonography are extremely rare.
A 12-day-old female presented with swelling of the anterior tongue. The obstetrician had detected significant tongue swelling on fetal ultrasonography in the 35th gestational week. The female was born by cesarean delivery at gestational week 39. She soon became dyspneic, and the cyst was aspirated. After the aspiration, her breathing recovered and she started breastfeeding. The cyst was excised under general anesthesia on the 67th day. Histopathologic examination showed that that cyst wall consisted of a lining of columnar gastrointestinal-type epithelium and pseudostratified ciliated epithelium. The patient restarted breastfeeding 3 h after surgery. The postoperative course was uneventful.
Airway distress and feeding difficulty were successfully avoided by cyst aspiration, and surgical resection was performed with no perioperative complications.
Core tip: Heterotopic gastrointestinal cysts have gastrointestinal epithelium in the cyst wall and rarely occur in the oral cavity. When these cysts do occur in the oral cavity, most are found in the neonatal period. However, heterotopic gastrointestinal cysts that are diagnosed as a congenital tongue cyst by routine ultrasonography are extremely rare. In such cases, airway management immediately after delivery is particularly important, and intratracheal intubation or reduction procedures may be required. We successfully avoided airway distress and feeding difficulty by performing cyst aspiration. Cyst aspiration may improve the outcome in such rare cases.