Epidermoid cyst - floor of the mouth

Case contributed by Dr Mostafa Mahmoud El-Feky


Dysphagia, difficult speech and mastication. Submandibular and floor of mouth swelling.

Patient Data

Age: 30 years
Gender: Male

CT neck

A large thin-walled cystic lesion is noted at the floor of the mouth with homogeneous fluid density (14 HU) measuring 9.2 x 5.2 x 6.0 cm in AP, ML and CC dimensions. It is stretching and displacing the genioglossus and mylohyoid muscles downwards. Inferiorly, it is reaching the hyoid bone with no erosion or related extensions.

Both submandibular glands are average in size with no stones or inflammatory changes. Moderate bilateral dilatation of intraglandular submandibular ducts bilaterally, likely due to the mass effect of the large cystic lesion of the floor of the mouth.

Case Discussion

Epidermoid cyst at the floor of the mouth is very rare. The suggestive diagnostic criteria at this location are midline well defined thin-walled lesion with fluid density content resting at the floor of the mouth with absent fat content unlike dermoid cyst. Epidermoid cyst in the floor of the mouth occurs as a result of entrapped ectodermal tissue of the first and second branchial arches, which fuse during the third and fourth weeks in utero. Although congenital, they are diagnosed in second or third decade of life.

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Case information

rID: 64463
Published: 24th Nov 2018
Last edited: 8th Dec 2018
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Dar El Ashaa Center

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