title: Management of a large antenatally recognized foregut duplication cyst of the tongue causing respiratory distress at birth.
abstract: OBJECTIVE
  Foregut duplication cysts are benign developmental anomalies occurring along the foregut-derived portion of the alimentary tract. Several cases of foregut duplications in the head and neck region have been reported, most without airway symptoms. This case is an antenatally recognized anterior tongue lesion leading to respiratory difficulties at birth that was successfully managed by a coordinated fetal care team.
  
  
  METHODS
  We describe a 4.16-kg female born at full term whose anterior tongue lesion was noted on routine prenatal ultrasound. An airway management plan was developed by a multidisciplinary fetal care team, and the airway was controlled at the time of cesarean delivery. The lesion was completely excised on the sixth day of life without complications.
  
  
  CONCLUSIONS
  Given the extensive differential diagnosis of cystic head and neck lesions in neonates, imaging is recommended to localize and characterize the lesion because management of these lesions may differ substantially. For cases that are diagnosed antenatally, coordination of a multidisciplinary fetal care team and early discussions can optimize the predelivery workup and provide clear delivery and airway management plans. We recommend complete surgical excision of oral foregut duplication cysts in the perinatal period to prevent complications such as feeding difficulties, infection, and ulceration.
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Gantwerker
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts.
authors.forename: Amy Lawrason
authors.initials: AL
authors.lastname: Hughes
authors.affiliation: Department of Radiology, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts.
authors.forename: V Michelle
authors.initials: VM
authors.lastname: Silvera
authors.affiliation: Department of Pathology, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts.
authors.forename: Sara O
authors.initials: SO
authors.lastname: Vargas
authors.affiliation: Department of Otolaryngology and Communication Enhancement, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts.
authors.forename: Reza
authors.initials: R
authors.lastname: Rahbar
mesh_terms: D003560:Cysts / Q000150:complications / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D012131:Respiratory Insufficiency / Q000209:etiology* / Q000601:surgery; D014060:Tongue Diseases / Q000150:complications / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D016216:Ultrasonography, Prenatal