Sublingual dermoid: an uncommon presentation and review of literature
Keywords:Dermoid cyst, Sublingual, Ranula, Cystic swelling
Dermoid cysts are generally seen in the areas of embryonic fusion, in the midline, either following sequestration of ectodermal tissue, or due to failure of separation of the ectoderm from the mesoderm during third to fifth weeks of gestation. Patient information: An eighteen year old female patient presented to department of otorhinolaryngology with a painless swelling in the floor of mouth on right side. Physical examination: the swelling was cystic in consistency, bluish in color, translucent, globular shaped, nontender with a right soft submental swelling. Diagnostic assessment: both ultrasound and computed tomography of the swelling was done which reported as ranula. Interventions; under aseptic precautions and general anesthesia, elective excision of the cyst was done by intraoral approach and specimen was sent for histopathological examination. Postoperative period was uneventful. Follow up and outcome: on follow up the patient was stable and the histopathological report revealed dermoid cyst. A lateral to midline presentation of sublingual dermoid cyst in the floor of mouth with recent occurrence of symptoms and no history of any trauma is rare, hence should be considered as one of the differential diagnosis for floor of the mouth cystic swellings. Ranula and dermoid cysts have similar clinical presentation with similar ultrasound, computed tomography and magnetic resonance imaging findings. The only distinguishable investigation is histopathological examination and all the specimens have to be sent for histopathological examination irrespective of the preoperative investigation reports.
Philipsen H, Reichart P. Revision of the 1992-edition of the WHO histological typing of odontogenic tumours. A suggestion. J Oral Pathol Med.2002;31(5):253-8.
Koca H, Seckin T, Sipahi A, Kazanc A. Epidermoid cyst in the floor of the mouth: Report of a case. Quintessence Int. 2007;38(6):473-7.
Erich JB. Sebaceous, mucous, dermoid and epidermoid cysts. Am J Surg. 1940;50(3):672-7.
Al-Khateeb T, Al-Masri N, Al-Zoubi F. Cutaneous cysts of the head and neck. J Oral Maxillofac Surg. 2009;67(1):52-7.
Seah TE, Sufyan W, Singh B. Case report of a dermoid cyst at the floor of the mouth. Ann Acad Med Singap. 2004;33(4 Suppl):77-9.
Dabholkar JP, Patole AD, Sheth AS, Saaj R. Congenital cystic lesions in head and neck. Indian J Otolaryngol Head Neck Surg. 2003;55(2):128-30.
Görür K, Talas DU, Ozcan C. An unusual presentation of neck dermoid cyst. Eur Arch Otorhinolaryngol. 2005;262(4):353-5.
Mathews J, Lancaster J, O’Sullivan G. True lateral dermoid cyst of the ﬂoor of the mouth. J Laryngol Otol. 2001;115(04):333-5.
Bloom D, Carvalho D, Edmonds J, Magit A. Neonatal dermoid cyst of the floor of the mouth extending to the midline neck. Arch Otolaryngol Head Neck Surg. 2002;128(1):68-70.
Vargas FJ, Lorenzo RJ, Aneiros FJ, Sainz QM. Dermoid cyst of the floor of the mouth. Acta Otorrinolaringol. 2007;58(1):31-3.
Jain H, Singh S, Singh A. Giant sublingual dermoid cyst in floor of the mouth. J Maxillofac Oral Surg. 2011;11(2):235-7.
Meyer I. Dermoid cysts (dermoids) of the ﬂoor of the mouth. Oral Surg Oral Med, Oral Pathol. 1955; 8(11):1149-64.
Oatis GW, Hartman GL, Robertson GR, Sugg WE. Dermoid cyst of the ﬂoor of the mouth. Report of a case. Oral Surg, Oral Med, Oral Pathol. 1975;30(2): 192-6.
Taylor BW, Erich JB, Dockerty MB. Dermoids of the head and neck. Minn Med. 1960;49:1535-40.
Longo F, Maremonti P, Mangone G, De Maria G, Califano L. Midline (Dermoid) cysts of the floor of the mouth: report of 16 cases and review of surgical techniques. Plast Reconstr Surg. 2003;112(6):1560-5.
Lin HW, Silver AL, Cunnane ME, Sadow PM, Kie DA. Lateral dermoid cyst of the ﬂoor of mouth: unusual radiologic and pathologic ﬁndings. Auris Nasus Larynx. 2011;38(5):650-3.
Torres J, Higa T. Epidermoidal cysts in the oral cavity. Oral Surg Oral Med, Oral Pathol. 1970;30 (5):592-600.
Milam M, Hill S, Manaligod J. Lingual dermoid cysts. Otolaryngol Head Neck Surg. 2003;128(3): 428-9.
King RC, Smith BR, Burk JL. Dermoid cyst in the floor of the mouth. Oral Surg Oral Med, Oral Pathol. 1994;78(5):567-76.
Di Francesco A, Chiapasco M, Biglioli F, Ancona D. Intraoral approach to large dermoid cysts of the ﬂoor of the mouth: a technical note. Int J Oral Maxillofac Surg. 1995;24(3):233-5.
Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and maxillofacial pathology. 3rd ed. St. Louis: Saunders Elsevier; 2009:33-5.
Sanal HT. Ultrasound ﬁnding of dermoid cysts located in neck region: sack-of-marbles sign. Available at: www.KBB-Forum.net. Accessed on 15 March 2011.
Turki IM, Kaddour AK, Wann AR, Ginisty D. Dermoid cyst of the submandibular space. Fr ORL. 2005;89:167-9.
Teszler C, El-Naaj I, Emodi O, Luntz M, Peled M. Dermoid cysts of the lateral floor of the mouth: a comprehensive anatomo-surgical classification of cysts of the oral floor. J Oral Maxillofac Surg. 2007; 65(2):327-32.
Tuffin, J, Theaker, E. True lateral dermoid cyst of the neck. Int J Oral Maxillofac Surg. 1991;20(5): 275-6.
Wong K, Lee Y, King A, Ahuja A. Imaging of cystic or cyst like neck masses. Clin Radiol. 2008; 63(6):613-22.
El-Hakim I, Alyamani A. Alternative surgical approaches for excision of dermoid cyst of the floor of mouth. Int J Oral Maxillofac Surg. 2008;37(5): 497-9.