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Radiology Forum
November 1999

Quiz Case 1

Author Affiliations


Arch Otolaryngol Head Neck Surg. 1999;125(11):1270. doi:

Histopathologic examination revealed an epithelial-lined cavity with dermal appendages similar to hair follicles and sebaceous glands. A diagnosis of submandibular dermoid cyst was made. The patient healed well and, after 1 year of follow-up, has not had a recurrence.

Dermoid cyst is an uncommon congenital epithelium-lined cavity containing tissues of mesodermal and ectodermal origin.1 Consequently, it can include skin appendages, cartilage, or bone; however, it does not contain endodermal tissues. In 1936, New and Erich2 reviewed 1485 cases of dermoid cyst, 6.9% of which were located in the head and neck region, and approximately 23% of these were found in the floor of the mouth. There is no sexual predilection.2 The dermoid cyst in the floor of the mouth usually presents in second or third decade of life, with a slow painless increase in size over months.3,4 There is no universally accepted classification. The most likely pathogenesis is formation of inclusion cysts along the lines of embryological fusion.3 The cysts are usually lined by keratinized stratified squamous epithelium with sebaceous glands and various skin adnexae. They are well encapsulated and may have a fibrous stalk or an epithelial tract. They may also contain yellowish cheesy material.1

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