Pediatric Surgery International

, Volume 21, Issue 4, pp 289–291 | Cite as

Antenatally diagnosed duplication cyst of the tongue: modern imaging modalities assist perinatal management

  • N. J. Hall
  • N. Ade-Ajayi
  • D. Peebles
  • A. Pierro
Case Report


When a foetal abnormality is detected during routine antenatal screening, further information is required in order to plan the remainder of the pregnancy and perinatal management. If a lesion is detected in the foetal mouth or neck, there may be compromise of the foetal airway. The ex-utero intrapartum (EXIT) procedure has recently been developed to allow lifesaving foetal surgery to be performed during delivery of such cases whilst relying on placental support. Detailed antenatal assessment is essential when planning the EXIT procedure, and modern imaging modalities may be implemented. We illustrate this by reporting a rare case of enteric duplication cyst arising from the base of the tongue, which was detected on routine antenatal ultrasound scan. Subsequent imaging using foetal MRI and colour Doppler ultrasound reassured us that the foetal airway was patent, and an EXIT procedure was avoided.


Antenatal diagnosis Foetal imaging EXIT procedure Duplication cyst 


  1. 1.
    Poutamo J, Vanninen R, Partanen K, et al. (1999) Magnetic resonance imaging supplements ultrasonographic imaging of the posterior fossa, pharynx and neck in malformed fetuses. Ultrasound Obstet Gynecol 13:327–334CrossRefPubMedGoogle Scholar
  2. 2.
    Quinn TM, Hubbard AM, Adzick NS (1998) Prenatal magnetic resonance imaging enhances fetal diagnosis. J Pediatr Surg 33:553–558PubMedGoogle Scholar
  3. 3.
    Duncan BW, Adzick NS, Eraklis A (1992) Retroperitoneal alimentary tract duplications detected in utero. J Pediatr Surg 27:1231–1233CrossRefGoogle Scholar
  4. 4.
    Goyert GL, Blitz D, Gibson P, et al. (1991) Prenatal diagnosis of duplication cyst of the pylorus. Prenat Diagn 11:483–486Google Scholar
  5. 5.
    Ladd WE, Gross RE (1940) Surgical treatment of duplication of the alimentary tract: enterogenous cysts, enteric cysts, or ileum duplex. Surg Gynecol Obstet 70:295–307Google Scholar
  6. 6.
    Chuang MT, Barba FA, Kaneko M, et al. (1981) Adenocarcinoma arising in an intrathoracic duplication cyst of foregut origin: a case report with review of the literature. Cancer 47:1887–1890Google Scholar
  7. 7.
    Tucker R, Maddalozzo J, Chou P (2000) Sublingual enteric duplication cyst. Arch Pathol Lab Med 124:614–615Google Scholar
  8. 8.
    Harrison MR, Anderson J, Rosen MA, et al. (1982) Fetal surgery in the primate I. Anesthetic, surgical, and tocolytic management to maximize fetal-neonatal survival. J Pediatr Surg 17:115–122Google Scholar
  9. 9.
    Mychaliska GB, Bealer JF, Graf JL, et al. (1997) Operating on placental support: the ex utero intrapartum treatment procedure. J Pediatr Surg 32:227–230CrossRefGoogle Scholar
  10. 10.
    Bui TH, Grunewald C, Frenckner B, et al. (2000) Successful EXIT (ex utero intrapartum treatment) procedure in a fetus diagnosed prenatally with congenital high-airway obstruction syndrome due to laryngeal atresia. Eur J Pediatr Surg 10:328–333Google Scholar
  11. 11.
    Liechty KW, Crombleholme TM, Flake AW, et al. (1997) Intrapartum airway management for giant fetal neck masses: the EXIT (ex utero intrapartum treatment) procedure. Am J Obstet Gynecol 177:870–874Google Scholar
  12. 12.
    O’Callaghan SP, Walker P, Wake C, et al. (1997) Perinatal care of a woman with the prenatal diagnosis of a massive fetal neck tumour (cervical teratoma). Br J Obstet Gynaecol 104:261–263Google Scholar
  13. 13.
    Carnes KI, Magin RL (1996) Effects of in utero exposure to 4.7 T MR imaging conditions on fetal growth and testicular development in the mouse. Magn Reson Imaging 14:263–274CrossRefGoogle Scholar
  14. 14.
    Tyndall DA (1993) MRI effects on craniofacial size and crown-rump length in C57BL/6J mice in 1.5 T fields. Oral Surg Oral Med Oral Pathol 76:655–660Google Scholar
  15. 15.
    Myers C, Duncan KR, Gowland PA, et al. (1998) Failure to detect intrauterine growth restriction following in utero exposure to MRI. Br J Radiol 71:549–551Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • N. J. Hall
    • 1
  • N. Ade-Ajayi
    • 1
  • D. Peebles
    • 2
  • A. Pierro
    • 1
  1. 1.Department of Paediatric Surgery, Institute of Child HealthGreat Ormond Street Hospital for ChildrenLondonUK
  2. 2.Department of Foetal MedicineUniversity College London HospitalLondonUK

Personalised recommendations