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      Sublingual epidermoid cyst: a case report

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          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 × 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.

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          Midline (dermoid) cysts of the floor of the mouth: report of 16 cases and review of surgical techniques.

          A retrospective review of 16 cases of midline (dermoid) cysts of the floor of the mouth is presented, evaluating the different surgical approaches. Sixteen cases of patients with a diagnosis of midline cyst of the floor of the mouth, treated at the Maxillofacial Surgery Department of the School of Medicine and Surgery of the "Federico II" University of Naples (Naples, Italy), were observed over a 10-year period, between 1988 and 1998; age, sex, localization, diagnostic technique, and type of treatment were evaluated. Male patients were more frequently affected, with a male-to-female ratio of 3:1 (12:4 cases). Patients ranged in age from 5 to 51 years (average age, 27.8 years). The preoperative assessment was made using ultrasonography in all cases but one, computed tomography in eight cases, and magnetic resonance imaging in three cases. Regarding surgical techniques used, a transcutaneous approach was adopted for median geniohyoid cysts, an extended median glossotomy technique was used for very large median genioglossal cysts, a median glossotomy technique was used for median genioglossal cysts, 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 modest edema in three cases. Follow-up ranged between 24 months and 12 years; no relapses or malignant changes were observed. In the authors' experience, the intraoral approach was also effective for the treatment of large lesions and led to very good cosmetic and functional results, whereas the extraoral incision was necessary only when the cysts were under the geniohyoid muscle.
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            Sublingual epidermoid cyst.

            Dermoid and epidermoid cysts are developmental pathologies that occur in the head and neck with an incidence ranging from 1.6 to 6.9%, and they represent less than 0.01% of all oral cavity cysts. Our purpose is to report a case of sublingual epidermoid cyst of the floor of the mouth. We studied and operated on an 18-year-old white male patient showing a large swelling of oral floor. His main symptoms were difficulty breathing, swallowing, and speaking. At his birth the patient's tongue was adherent to the floor of the mouth. His father had the same problem at birth. Both father and son underwent surgical separation of tongue, during the post-neonatal period. After the surgical removal of the swelling, under general anesthesia, all the patient's symptoms were missed. Histological examination of the mass confirmed the diagnosis of an epidermoid cyst. No relapse of the lesion was present in ten months of follow-up. Many theories are proposed on the etiology of the epidermoid and dermoid cyst. In this case a traumatic event can be found, such as an operation of the tongue in neonatal age. However a multifactorial origin must be assumed for justifying the fact that the patient's father did not develop a dermoid cyst although he had the same problem of an adherent tongue and was operated on.
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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.

                Author and article information

                Journal
                J Med Case Reports
                Journal of Medical Case Reports
                BioMed Central (London )
                1752-1947
                2007
                17 September 2007
                : 1
                : 87
                Affiliations
                [1 ]Department of Otolaryngology, İzmir Teaching and Research Hospital, Bozyaka 35220 İzmir, Turkey
                [2 ]Department of Pathology, İzmir Teaching and Research Hospital, Bozyaka 35220 İzmir, Turkey
                [3 ]Department of Radiology, İzmir Teaching and Research Hospital, Bozyaka 35220 İzmir, Turkey
                Article
                1752-1947-1-87
                10.1186/1752-1947-1-87
                2020471
                17875211
                7a6ba37c-1a97-411d-beb4-df45c3b7ba00
                Copyright © 2007 Kandogan et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 4 June 2007
                : 17 September 2007
                Categories
                Case Report

                Medicine
                Medicine

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