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Clinical Problem Solving: Radiology
May 1, 2008

Radiology Quiz Case 1: Diagnosis

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2008;134(5):556-557. doi:10.1001/archotol.134.5.556

Dermoid cysts occur in many locations throughout the body and are found in the head and neck area in only about 7% of patients. They are relatively rare in the oral cavity, accounting for only approximately 1.6% of cystic benign tumors in this region.1Clinically, dermoid cysts generally occur in the second or third decade of life; however, presentation may range from the first to sixth decades of life. Although they are present at birth, they typically become evident later in life and are frequently discovered secondary to inflammation. The male-female ratio has been noted to be 3:1.2The cysts usually occur as a slow-growing, sublingual, midline swelling either above or below the mylohyoid muscle. As they expand, they may elevate the floor of the mouth and the tongue,3project into the submental region, extend through the mylohyoid muscle into the submandibular space, or present as a lateral neck mass. A large dermoid cyst may interfere with articulation, mastication, or deglutition, and patients may present with dysphagia, dysphonia, or dyspnea.2,4Typically, however, the lesions develop as an asymptomatic, painless swelling in the anterior portion of the floor of the mouth.2

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