A case report of oral heterotopic gastrointestinal cysts (HGIC) and review of the literature

Abstract

Heterotopic gastric mucosa is the displacement or sequestration of gastric mucosa cells to other parts of the alimentary tract. 1 "Heterotopia" (Greek origin) refers to the finding of normal tissue in a foreign site entirely separate from the main organ. Following an extensive literature search, we found that heterotopic gastric mucosa in the oral cavity is an extremely rare condition with only 68 reported cases in the English literature with the first case being reported in 1927 by Schultz in the floor of the mouth and Toyama in

Quiste gastrointestinal heterotópico en la cavidad oral

“…By embryonic induction effect, these cells can be differentiated into various types of epithelium (gastric, colonic type, intestinal, respiratory, squamous, and glandular epithelium). 4,7,10 Another theory states that it could be a pathology that develops from retention cysts where dedifferentiation into other types of epithelia. 3 The preoperative evaluation of lingual cystic mass in newborns may involve: palpation, ultrasound, computed tomography and magnetic resonance imaging; however, the latter are a risk for the child because of sedation, but when the lesion occupies a large area, magnetic resonance imaging is an effective tool to determine its extension.…”

“…Among them are congenital ranula, teratoma, dermoid and epidermoid cyst, duplication cyst of the anterior intestine, hemangioma, lymphangioma and thyroglossal duct cyst. 4,8 There is still no consensus on the appropriate age for treatment. It has been proposed that for safe surgery it is better to wait until the first year, although this is controversial because if the lesion causes impairment of vital functions, then it should be performed as soon as possible.…”

“…Its etiology is still poorly understood and the most accepted theory hypothesizes that around the 4th week of embryonic development, some islands of endodermal cells undergo a process of sequestration of the stomodeum. 4 This lesion may be located on the tongue and floor of mouth on the anterior dorsum and ventral surface, on the midline or laterally. It is of unilocular appearance and on palpation is fluctuant and with greater consistency.…”

“…It is of unilocular appearance and on palpation is fluctuant and with greater consistency. 4,5 Patients may have no symptoms, but when expanding and reaching huge dimensions, it makes proper feeding difficult. Regarding newborns, sucking becomes a difficult task therefore, it prevents them from breastfeeding and causes excessive salivation and partially airway compromise; moreover, adults may have speaking difficulty.…”

“…According to the previous information, no evidence of atypia or malignancy has been reported and for certain cases immunohistochemistry or special stains would be useful. 2,4,5 The suggested treatment for this pathology is complete conservative surgical excision in order to protect nearby structures and keep the patient under control. Recurrence is uncommon, therefore a good prognosis.…”