Giant Dermoid Cyst Causing Dysphagia and Dyspnea

Area of Science:

• Head and Neck Surgery
• Dermatology
• Pathology

Background:

• Dermoid cysts are benign tumors, commonly found in young adults.
• The floor of the mouth is a frequent site for dermoid cysts.
• While often asymptomatic, they can cause symptoms due to size or secondary changes.

Observation:

• A 19-year-old female presented with dyspnea, dysphagia, and a growing submental mass.
• The mass obstructed the airway, preventing endotracheal intubation due to posterior displacement of the tongue base.
• Emergency tracheostomy was performed to secure the airway for surgical intervention.

Findings:

• Histopathological examination revealed a cystic mass lined by keratinized stratified squamous epithelium with dermal appendages.
• The diagnosis was confirmed as a dermoid cyst of the submental region.
• The cyst contained keratin, consistent with its nature.

Implications:

• This case underscores the potential for submental dermoid cysts to cause acute airway compromise.
• Elective tracheostomy is a critical management option for patients with rapidly enlarging masses causing airway obstruction.
• Prompt surgical intervention is necessary for symptomatic dermoid cysts, especially those affecting the airway.