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A Pediatric Lateral Submental Mass: A Rare Presentation of Dermoid Cyst
Adam Sauer1, Anish Abrol2, Claudia I Cabrera2
1Case Western Reserve University School of Medicine, Health Education Campus, Cleveland, OH, USA.
Insights
Dermoid cysts, rare in the lateral submental area, are benign growths typically seen in young children. This case highlights a dermoid cyst in a 10-year-old, emphasizing accurate diagnosis and surgical removal for favorable outcomes.
Area of Science:
- Dermatology
- Pediatric Surgery
- Head and Neck Surgery
Background:
- Dermoid cysts are benign germ cell tumors originating from ectoderm and mesoderm.
- They commonly affect children under 5, with 7% occurring in the head and neck region.
- Lesions in the head and neck are typically midline masses, classified by their relation to floor of mouth muscles.
Observation:
- A 10-year-old female presented with a 2-week history of right submental swelling.
- Physical examination revealed nontender fullness without erythema or induration.
- Imaging confirmed a cystic mass in the right lateral floor of the mouth.
Findings:
- Histopathology confirmed the mass as a dermoid cyst.
- This diagnosis is unusual given the lateral submental location.
- Complete intraoral surgical excision was performed successfully.
Implications:
- Submental masses have a diverse differential diagnosis, with dermoid cysts being rare in lateral presentations.
- Accurate diagnosis and complete surgical excision are crucial for successful patient outcomes.
- This case underscores the importance of considering dermoid cysts even in atypical locations.
Abstract:
Dermoid cysts are benign cutaneous neoplasms that contain germ cells from the ectoderm and mesoderm. Approximately 70% are diagnosed during childhood before the age of 5. Although they can present throughout the body, the prevalence is 7% for those arising from the head and neck. These lesions present primarily as midline masses and are classified as sublingual, submental, or overlapping depending on their relationship with the muscles of the floor of mouth. A 10-year-old female presented with a 2-week history of right submental swelling. She denied pain, dysphagia, odynophagia, or respiratory distress. Physical examination showed nontender fullness of the submental region without erythema or induration and no palpable cervical lymphadenopathy. Ultrasound showed an oval-shaped cystic mass measuring 4.8 × 4.0 × 2.6 cm. After a course of clindamycin, a computed tomography was obtained which showed a right 4.5 × 4.0 × 2.6 cm fluid filled lesion, within the right lateral floor of mouth. Intraoral resection was performed and the mass was freed from the geniohyoid and mylohyoid. Histopathology was consistent with a dermoid cyst. Submental masses have a broad differential, but rarely are they dermoid cysts if they arise lateral to the midline. With appropriate diagnosis and total surgical excision, patients and their families can be reassured in similar cases.
