Unusual giant plunging sublingual epidermoid cyst: A case report and review of literature

Key Clinical MessageWhen treating a painless or asymptomatic mass in the submental or floor of the mouth, sublingual epidermoid cyst should be considered. Despite its irregularity, preventing malignant transformation is essential for a successful outcome.AbstractDermoid and epidermoid cysts are rarely found in the head and neck region. They account for less than 0.01% of all oral cavity cysts. This is a rare case of a sublingual epidermoid cyst of the oral cavity in a 25-year-old male. The patient presented with a painless sublingual swelling for a duration of 1 month. The clinical examination revealed a non-tender swelling in the sublingual region extending to the submental triangle. Magnetic resonance imaging confirmed a 6.2 x 7.7 x 3.2 cm cystic lesion in the sublingual space. Fine needle aspiration cytology confirmed dermoid cyst contents. Intra-oral surgical excision under general anesthesia was performed successfully. Histopathological analysis revealed that the cyst wall was lined by stratified squamous epithelium. The presence of a prominent granular layer and keratin flakes confirmed the diagnosis of an epidermoid cyst. Postoperative recovery was good, and no recurrence was observed during follow-up. This case emphasizes the infrequent and unusual presentation of a case of a giant plunging sublingual epidermoid cyst and promotes awareness and potential studies in the enhancement of patient care in this area. (A) Intra-oral approach for excision of the cyst, (B) Transverse incision over the mucosa above the swelling using Co2 laser, (C) Extirpation of the cyst wall, (D) Excised cyst specimen with pultaceous content.image