Intra-orai Duplication Cyst By Stephen Brown and Richard Kerr-Wilson Several cases of intra-oral cysts lined by gastrointestinal mucosa have been reported in the literature. Many were believed to be dermoid cysts containing heterotopic mucosa. 1~3 However, in a review of 68 duplications of the alimentary tract, Gross 4 included one case of a cyst at the base of the tongue that was lined by colonic epithelium. Lister and Zachary ~ also reported three similar cases that they believed were duplications of the alimentary tract.
CASE REPORT D.G., aged 11 mo, presented with a cystic lesion on the ventral surface of his tongue in the midline. The cyst had been l~bsent from birth and had been growing slowly. It had not interfered with feeding or breathing. The cyst, which measured 18 x 13 x 10 ram, was excised.
H ISTOLOGY The cyst was partly lined by stratified squamous and pseudostratified ciliated columnar epithelium. In its deeper portion was a focus of gastric mucosa consisting of mucussecreting cells of gastric type. Below this were gastric
Fig. 1. 22O
glands, consisting of peptic and parietal cells (Fig, 1), The whole was encased in a smooth muscle coat that e~tended between the gastric glands, and was apart from the striated muscle of the tongue.
DISCUSSION Duplications can occur at any site along the alimentary tract. For a cyst to be classified as a duplication, it must satisfy three criteria: (1) It must have a coat of smooth muscle; (2) It must be attached to some part of the alimentary tract; and (3) It must have a mucosal lining similar to that of some part of the alimentary tract, although not necessarily the part to which it is attached. Since all three criteria were satisfied in the case reported here, we believe
From The Hospital for Sick Children, Great Ormond Street, London, England. Address reprint requests to Stephen Brown, The Hospital for Sick Children, Great Ormond Street, London, England, 9 1978 by Grune & Stratton, Inc, 0022-3468/78/1301-0022501,00/0
Gastric glands consisting of peptic and parieta! cells, surrounded by a smooth muscle coat, Hemar
Journal of Pediatric Surgery, Vol, 13, No, ! (February),t 978
and aosin, •
95
96
CASE REPORT
that it represents an intra-oral duplication cyst of the alimentary tract.
2. Quinn JH, Robinson WC: Multiple congenital cysts of the floor of the mouth in a newborn infant. Oral Surg 20:1, 1965
ACKNOWLEDGMENT
We wish to thank Professor A. W. Wilkinson for permission to report this case.
3. Giunta J, Cataldo E: Lymphoepithelial cysts of the oral mucosa. Oral Surg 35:77, 1973
REFERENCES
4. Gross RE: The Surgery of Infancy and Childhood. Philadelphia, WB Saunders, 1953
1. Gorlin RJ, Kalnins V, lzant R J: Occurrence of heterotopic mucosa in the tongue. J Pediatr 64:604, 1964
5. Lister J, Zachary RB: Cystic duplications in the tongue. J Pediatr Surg 3:491, 1968
CASE REPORT D.G., aged 11 mo, presented with a cystic lesion on the ventral surface of his tongue in the midline. The cyst had been l~bsent from birth and had been growing slowly. It had not interfered with feeding or breathing. The cyst, which measured 18 x 13 x 10 ram, was excised.
H ISTOLOGY The cyst was partly lined by stratified squamous and pseudostratified ciliated columnar epithelium. In its deeper portion was a focus of gastric mucosa consisting of mucussecreting cells of gastric type. Below this were gastric
Fig. 1. 22O
glands, consisting of peptic and parietal cells (Fig, 1), The whole was encased in a smooth muscle coat that e~tended between the gastric glands, and was apart from the striated muscle of the tongue.
DISCUSSION Duplications can occur at any site along the alimentary tract. For a cyst to be classified as a duplication, it must satisfy three criteria: (1) It must have a coat of smooth muscle; (2) It must be attached to some part of the alimentary tract; and (3) It must have a mucosal lining similar to that of some part of the alimentary tract, although not necessarily the part to which it is attached. Since all three criteria were satisfied in the case reported here, we believe
From The Hospital for Sick Children, Great Ormond Street, London, England. Address reprint requests to Stephen Brown, The Hospital for Sick Children, Great Ormond Street, London, England, 9 1978 by Grune & Stratton, Inc, 0022-3468/78/1301-0022501,00/0
Gastric glands consisting of peptic and parieta! cells, surrounded by a smooth muscle coat, Hemar
Journal of Pediatric Surgery, Vol, 13, No, ! (February),t 978
and aosin, •
95
96
CASE REPORT
that it represents an intra-oral duplication cyst of the alimentary tract.
2. Quinn JH, Robinson WC: Multiple congenital cysts of the floor of the mouth in a newborn infant. Oral Surg 20:1, 1965
ACKNOWLEDGMENT
We wish to thank Professor A. W. Wilkinson for permission to report this case.
3. Giunta J, Cataldo E: Lymphoepithelial cysts of the oral mucosa. Oral Surg 35:77, 1973
REFERENCES
4. Gross RE: The Surgery of Infancy and Childhood. Philadelphia, WB Saunders, 1953
1. Gorlin RJ, Kalnins V, lzant R J: Occurrence of heterotopic mucosa in the tongue. J Pediatr 64:604, 1964
5. Lister J, Zachary RB: Cystic duplications in the tongue. J Pediatr Surg 3:491, 1968
