Sublingual Dermoid Cyst: A Diagnostic Challenge During Clinical Examination

Area of Science:

• Oral and Maxillofacial Surgery
• Dermatology
• Pediatric Surgery

Background:

• Epidermoid cysts are benign lesions with three classifications: epidermoid, dermoid, and teratoid cysts.
• Dermoid cysts are distinguished by the presence of skin adnexa within the cyst lining.
• These cysts can occur in various body locations, including the oral cavity.

Observation:

• A 13-year-old boy presented with a 4-year history of a gradually enlarging, initially painless sublingual mass.
• The mass, measuring 5x6 cm on the tongue, became painful over the last 3 months, causing eating difficulties and dysarthria.
• Physical examination revealed a soft, fluctuant mass; aspiration yielded turbid yellow fluid, suggestive of keratin.

Findings:

• Surgical excision confirmed the mass as a dermoid cyst of the tongue.
• Histopathological analysis revealed the presence of hair and fat within the cyst.
• The patient experienced no postoperative complications and was discharged the same day.

Implications:

• Dermoid cysts of the tongue are exceptionally rare, necessitating a high index of suspicion for diagnosis.
• Aspiration of cyst contents, showing characteristic yellow, cholesterol-rich fluid, aids in diagnosis.
• Complete surgical excision offers an excellent prognosis for tongue dermoid cysts.