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Retroductal Submandibular Gland Instillation and Localized Fractionated Irradiation in a Rat Model of Salivary Hypofunction

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Not every sublingual swelling is Ranula, a case report.

Mahmoud Khalefa¹, Marwa Saeed Yassin², Sarah Magdy Abdelmohsen³

¹Otorhinolaryngology department, faculty of medicine, Aswan university, Aswan, Egypt.

International Journal of Surgery Case Reports

|May 13, 2025

Summary

Sublingual epidermoid cysts are rare benign lesions that can cause significant symptoms like dysphagia and obstructive sleep apnea (OSA). Prompt diagnosis and surgical excision are key for effective management of these uncommon oral cysts.

Keywords:

Epidermoid cyst Magnetic resonance imaging (MRI)Ranula Sublingual Surgical excision

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Area of Science:

Oral pathology
Head and neck surgery
Diagnostic imaging

Background:

Sublingual epidermoid cysts are rare, benign ectodermal lesions.
They can cause dysphagia, speech and chewing difficulties, and obstructive sleep apnea (OSA).
Accurate diagnosis is crucial as symptoms may mimic other sublingual swellings like ranulas.

Observation:

A 22-year-old male presented with a persistent sublingual enlargement causing significant functional impairment.
Physical examination revealed a cyst displacing the tongue; MRI confirmed a 5x3.5 cm midline cystic mass.
The lesion was successfully excised via a transoral approach.

Findings:

Histopathology confirmed a keratinized sublingual epidermoid cyst, accounting for <0.01% of oral cysts.
The cyst was likely congenital or acquired due to trauma/sebaceous gland obstruction.
MRI proved vital in defining the cystic tumor and guiding treatment.

Implications:

Sublingual epidermoid cysts must be considered in the differential diagnosis of sublingual swellings.
This case highlights diagnostic and management challenges associated with rare oral lesions.
Surgical excision, particularly transoral approaches for smaller cysts, remains the definitive treatment.