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Sublingual epidermoid cyst: unusual diagnosis in Otorhinolaringology

Journal of Otolaryngology-ENT Research
Hugo Marcos, Tiago Soares Santos, Paulo Gonçalves, Débora Gonçalves, Guilherme Carvalho, Vera Miranda, Carlos Carvalho

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Dermoid and epidermoid cysts are rare in the head and neck, specially in the oral cavity, accounting for 1.6 %. It represents an even smaller percentage of all the oral cysts, less than 0.01%. Usually asymptomatic, however, occasionally, obstructive symptoms like dysphagia or speech difficulties are found. We present a case of a 32 years old female patient with a sublingual epidermoid cyst. The patient was referred to our ENT department with complaints of an oral mass, speech difficulties and solid food dysphagia for 1 month. Physical examination revealed a well circumscribed symmetrical mass on the floor of the mouth with no inflammatory signs, tender and fluctuant on palpation. Computed tomography (CT) was requested. CT scan showed a sublingual cystic mass inferiorly limited by the mylohyoid muscle. Aspiration was performed to improve symptoms until surgery. The liquid that resulted from aspiration showed a granulated white cheesy material. Enucleation of the cyst was performed intraorally in the operating room. Histopathologic investigation confirmed the diagnosis of epidermoid cyst. The patient fully recovered and there was no recurrence. Although rare, cases like this exist. There are several differential diagnoses and a high level of suspicion is necessary for a correct workup, diagnosis and follow-up. Surgical excision is usually necessary and curative.


Epidermoid cyst, Dermoid cyst, sublingual, enucleation