[Bronchogenic cyst of the tongue in an adult]

Etiological diagnosis of macroglossia: Systematic review and diagnostic algorithm

BACKGROUND

The objective of this literature review was to list the different etiologies of macroglossia reported in the literature, to identify characteristics that might guide diagnosis, and to create a diagnostic algorithm.

METHODS

The bibliographic search was carried out between October 2019 and July 2020 in the PubMed research base using the keywords "macroglossia" (MESH) and/or "tongue enlargement".

RESULTS

Of the 1711 references identified, 615 articles were excluded, and 1096 abstracts were reviewed. We classified the different etiologies identified according to their mechanism and whether they were congenital or acquired. The etiologies are divided into the following categories: genetic malformation syndromes, non-syndromic congenital malformations, endocrinopathies, neuromuscular diseases, storage disorders, infectious, inflammatory, traumatic, and iatrogenic diseases.

CONCLUSION

Based on this review, we propose a diagnostic algorithm for macroglossia according to the characteristics described. The most common diagnoses among acquired causes were amyloidosis (13.7%), endocrinopathies (8.8%), myopathies (4%) and tongue tumors (6.7%). The most common congenital causes were aneuploidy, lymphatic malformations, and Beckwith-Wiedemann syndrome, which is the main cause of congenital macroglossia, even if it appears isolated.

Ectopic bronchogenic cyst arising from the diaphragm: a rare case report and literature review

Background

Bronchogenic cysts can be caused by errors in the growth of the ventral foregut. Localization of the bronchogenic cyst (BC) varies depending on the level of the abnormal budding. They are usually located in the lungs and mediastinum. BCs of the diaphragm are a rare form of this abnormality.

Case presentation

A 66-year-old woman coughs and expectorates. CT scan evaluation revealed a soft tissue shadow of 6 × 5 cm in the left lung. Under thoracoscopic surgery, we found that the mass originated from the diaphragm away from the lung tissue, we completely removed the mass and the pathological result was diagnosed as BC.

Conclusions

The prognosis of ectopic BC is usually optimistic for benign tumors, as long as the tumor is completely removed.

Bone choristoma of the gingiva: A case report

INTRODUCTION

Bone choristoma is a benign tumor with normal histology and ectopic location. This paper aims to report a rare case of bone choristoma in the maxillary gingival location.

OBSERVATION

The authors report a case of a 39-year-old woman, with a history of maxillary full edentulousness, who consulted for a slight pain evolved for about six months, triggered by movements on the lesion. Clinical examination found growth at the level of the right maxillary gingival alveolar ridge. Surgical biopsy was indicated and performed under local anesthesia. The histological examination of the excisional specimen concluded at a bone choristoma. The patient had a good evolution after the surgical removal.

CONCLUSION

Choristoma is a rare and benign condition. The management is surgical.

Bronchogenic cyst of the tip of the tongue: report of two cases

INTRODUCTION

Lingual bronchogenic cyst is a rare congenital malformation, classified as a choristoma. It is lined by respiratory epithelium. Extrathoracic sites are rare and the tongue is an exceptional site.

CASE REPORT

The authors report two cases of bronchogenic cyst of the tip of the tongue in newborn infants. These two initially asymptomatic lesions gradually increased in size, leading to feeding difficulties in one case. MRI demonstrated well-demarcated, solitary, unilocular cystic images. Surgical resection was easily performed and histological examination concluded on bronchogenic cyst. An aberrant right upper lobe tracheal bronchus was also present in one case.

DISCUSSION

Lingual choristomas are rare and defined histologically according to the type of epithelium. The embryological origin of lingual bronchogenic cysts remains controversial. MRI is the imaging examination of choice to characterize these lesions, but the definitive diagnosis is based on histological examination. Early, systematic surgical enucleation of all congenital lingual cysts must be performed to prevent obstructive and infectious complications.

[Tongue cyst in children: foregut duplication, a possible diagnosis]

INTRODUCTION

Foregut duplication is a heterotopy of the digestive mucosa. The tongue localization is relatively uncommon, it presents as a cystic lesion. We report a series of five patients presenting with cysts of the tongue.

PATIENTS AND METHODS

This retrospective study was made on cases of foregut duplication of the lingual area, diagnosed between 1977 and 2008. We documented the patient's age, gender, symptoms, lesion localization, clinical radiological and pathological features, treatment, and outcome.

RESULTS

Four boys and one girl were included. Two cysts were diagnosed during antenatal screening, two during early infancy, and one at the age of 12 (after infectious complication). In every case, the diagnosis could be confirmed only after surgical removal.

DISCUSSION

Foregut duplication of the tongue is rare and its incidence is probably underestimated. This diagnosis should be suggested in case of congenital intraoral cysts. Treatment is surgical excision, and pathological examination confirms the diagnosis.