Sublingual epidermoid cyst: a case report

Abstract

Epidermoid and dermoid cysts represent less than 0.01% of all oral cavity cysts. The cysts can be defined as epidermoid when the lining presents only epithelium, dermoid cysts when skin adnexa are found, and teratoid cysts when other tissue such as muscle, cartilage, and bone are present.In this article, we present the case of an epidermoid cyst, with an oral as well as a submental component, in an 11 year old boy who presented with complaints of a mass in the oral cavity, difficulty chewing and swallowing of solid foods for about 3 years. He was admitted to the otolaryngology department. On examination, a mass displacing the tongue superiorly and posteriorly was noticed. An MRI scan was done and showed a 40 x 35 mm well-circumscribed non-enhancing cystic mass extending from the sublingual area to the level of the thyroid notch. The content of the cyst was homogenous. On examining the neck, a firm swelling was also noticed in the submental area, extending down to the thyroid notch. Under general anesthesia and with nasotracheal intubation, the patient underwent surgical removal of the mass. Extraorally, a midline submental horizontal incision was performed through the mucosa overlying the swelling and the cyst was dissected from the surrounding tissues and removed. On histological examination, acidophilic stratum corneum and basophilic dot like staining of stratum granulosum, which is the hallmark of an epidermoid cyst, were seen. The patient did well postoperatively, and no recurrence was noticed at the 6-months follow-up.

Figure 1

A MRI scan showing an 40 × 35 mm well-circumscribed non-enhancing cystic mass extending from the sublingual area to the thyroid notch level.

Figure 2

A per-operative view to the cyst.

Figure 3

Acidophilic stratum corneum and basophilic dot like staining of stratum granulosum were seen. Stratum granulosum is hallmark of epidermoid cyst. (H-E –200).