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      Epidermoid cyst: Report of two cases

      case-report

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          Abstract

          Epidermoid cysts (ECs) are uncommon, benign cystic lesions derived from the entrapment of surface epithelium or more often from the aberrant healing of infundibular epithelium during an episode of follicular inflammation. ECs occur anywhere on the body, particularly along embryonic fusion lines, most commonly on the face, scalp, neck, chest and upper back. Head and neck ECs constitute only about 7%, whereas only 1.6% of ECs are reported in the oral cavity. They comprise <0.01% of all the oral cysts. Floor of the mouth, tongue, lips, palate, jaws, etc., are some of the reported sites of ECs in the oral cavity. Microscopically, ECs are lined with plain stratified squamous epithelium filled with laminated layers of keratin. Here, we report two rare cases of ECs, one occurring in the gingival aspect and other in the lower third of face. The cases are reported due to rarity of ECs in the head and neck region.

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          Epidermoid cyst of submandibular region

          Epidermoid cysts are rare, slow-growing, benign, developmental cysts that are derived from abnormally situated ectodermal tissue. Epidermoid cysts may grow anywhere on the body and about 7% of them are located in the head and neck. These cyst arise from traumatic implantation of epithelium or entrapment of epithelial remnants during embryonic fusion. Histopathologically, they are lined by stratified squamous epithelium and ,lumen without any skin appendages. Here we present a case of epidermod cyst occurring in sub-mandibular region.
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            Epidermoid cyst in the floor of the mouth: report of a case.

            The occurrence of epidermoid cysts in the oral cavity is extremely rare. These cysts generally present slow and progressive growth and often are not diagnosed until the second or third decade of life. Epidermoid and dermoid cysts in the floor of the mouth are painless, doughy or fluctuant lesions and cause no symptoms until they are large enough to interfere with speech or eating. This article presents the case of a 20-year-old man with swelling in the floor of his mouth that was causing difficulties with speech and swallowing. After surgical removal of the cyst, histopathologic examination confirmed the diagnosis of epidermoid cyst. Characteristics of epidermoid cysts are described and surgical treatment discussed.
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              Epidermoid cyst of the floor of the mouth: two case reports

              Introduction Epidermoid cysts that appear in the midline floor of the mouth are, usually, a result of entrapped ectodermal tissue of the first and second branchial arches, which fuse during the third and fourth weeks in utero. The incidence in the floor of the mouth of the oral cavity is rare and development sites are the sublingual, submaxillary and submandibular spaces. It was present two cases of epidermoid cyst of the floor of the mouth and discussed the different surgical approaches for this lesion. Cases presentation Two cases of midline epidermoid cysts of the floor of the mouth are presented, evaluating the different surgical approaches. The preoperative assessment was made using ultrasonography and computed tomography in both cases. Regarding surgical techniques used, a transcutaneous approach was adopted when the cysts were under the geniohyoid muscle and a midline incision of the oral mucosa along the lingual frenulum was used for sublingual cysts. During the postoperative course, there were no complications, except for mild edema in one case. Follow-up ranged between 5 months and 4 years; no recurrence or malignant changes were observed. Conclusions Surgery of epidermoid cyst of the floor of the mouth is the treatment of choice. Access depends on the lesion's location in relation to the mylohyoid or geniohyoid muscles. If the cyst is located over the mylohyoid, surgery is carried out only through the oral cavity, whereas the extraoral incision was necessary only when the cysts were under the geniohyoid muscle.

                Author and article information

                Journal
                J Oral Maxillofac Pathol
                J Oral Maxillofac Pathol
                JOMFP
                Journal of Oral and Maxillofacial Pathology : JOMFP
                Medknow Publications & Media Pvt Ltd (India )
                0973-029X
                1998-393X
                Sep-Dec 2016
                : 20
                : 3
                : 546
                Affiliations
                [1]Department of Oral Medicine and Radiology, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
                [1 ]Department of Oral and Maxillofacial Pathology, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
                [2 ]Department of Oral Medicine and Radiology, Subbaiah Institute of Dental Sciences, Shimoga, Karnataka, India
                Author notes
                Address for correspondence: Dr. Surekha R Puranik, Department of Oral Medicine and Radiology, PMNM Dental College and Hospital, BVVS Campus, Bagalkot - 587 101, Karnataka, India. E-mail: puraniksurekha19@ 123456rediffmail.com
                Article
                JOMFP-20-546a
                10.4103/0973-029X.190965
                5051311
                27721628
                358e9cdd-9e1f-4fb8-bfe4-a689e2d05f25
                Copyright: © Journal of Oral and Maxillofacial Pathology

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 28 June 2016
                : 25 August 2016
                Categories
                Case Report

                Pathology
                epidermoid cyst,gingiva,keratin
                Pathology
                epidermoid cyst, gingiva, keratin

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