GIANT ORAL EPIDERMOID CYST EMPTYING AS AN EMERGENCY MANEUVER

Abstract

Epidermoid cyst (EC) in the oral cavity represents less than 0.01% of all cysts, being identified as 30 mm or less, yet giant cysts have been reported. Male, 21 years old, complaining of difficulty swallowing, speaking, and breathing. Intraoral examination showed tongue elevation with projection to the posterior region, obliterating the oropharynx due to a large soft painless bulge on the floor of the mouth. Magnetic resonance imaging revealed a well-defined homogeneous mass causing reduction of the airway space in the oropharynx and measuring 7.1 × 6.0 × 9.2 cm. Diagnostic hypotheses were dermoid or epidermoid cyst. Incisional biopsy and marsupialization were performed through intraoral access, with immediate reduction of the lesion. A yellowish pasty material, compatible with keratin, was drained until complete restoration of occlusion, swallowing, phonation, and breathing. Histopathological examination revealed an epidermoid cyst. The postoperative course was uneventful. EC in the mouth floor can reach large proportions, causing complications. Epidermoid cyst (EC) in the oral cavity represents less than 0.01% of all cysts, being identified as 30 mm or less, yet giant cysts have been reported. Male, 21 years old, complaining of difficulty swallowing, speaking, and breathing. Intraoral examination showed tongue elevation with projection to the posterior region, obliterating the oropharynx due to a large soft painless bulge on the floor of the mouth. Magnetic resonance imaging revealed a well-defined homogeneous mass causing reduction of the airway space in the oropharynx and measuring 7.1 × 6.0 × 9.2 cm. Diagnostic hypotheses were dermoid or epidermoid cyst. Incisional biopsy and marsupialization were performed through intraoral access, with immediate reduction of the lesion. A yellowish pasty material, compatible with keratin, was drained until complete restoration of occlusion, swallowing, phonation, and breathing. Histopathological examination revealed an epidermoid cyst. The postoperative course was uneventful. EC in the mouth floor can reach large proportions, causing complications.