Swelling of the Floor of the Mouth

Abstract

A 22-year-old man with no history of previous surgery or trauma of the oral cavity or neck presented to our Department with a 6-month history of an increasing swelling in the floor of the mouth. The patient did not report any eating or swallowing difficulties, but his elocution was mildly impaired. He had no pain or dyspnea. Physical examination revealed a large symmetrical, midline, soft, non-tender and non-pulsatile swelling of the floor of the mouth, with normal covering mucosa. There was mild displacement of the tongue superiorly and posteriorly (Figure, A). A magnetic resonance imaging scan of the head and neck was performed (Figure, B). Dermoid cyst is a benign developmental abnormality due to skin sequestration along the lines of embryonic closure. Dermoid cysts are congenital. However, they are often diagnosed later in life.1Velez-Cruz ME Gomez-Clavel JF Liceaga-Escalera CJ et al.Sublingual dermoid cyst in an infant: a case report and review of the literature.Clin Case Rep. 2020; 8: 1403-1408Crossref PubMed Scopus (1) Google Scholar About 7% of all dermoid cysts found in the body are formed in the head and neck region, and only 1.6% may occur within the oral cavity.1Velez-Cruz ME Gomez-Clavel JF Liceaga-Escalera CJ et al.Sublingual dermoid cyst in an infant: a case report and review of the literature.Clin Case Rep. 2020; 8: 1403-1408Crossref PubMed Scopus (1) Google Scholar Differential diagnoses are ranula, mucocele, thyroglossal duct cysts, ectopic thyroid tissue branchial cysts, hemangiolymphangiomas, hemangioma, neurofibroma, and lipoma. Bidigital palpation, ultrasound associated with a cytological puncture, computed tomography scan, and, at best, magnetic resonance imaging, are essential for etiological orientation in front of any oral floor lesion.1Velez-Cruz ME Gomez-Clavel JF Liceaga-Escalera CJ et al.Sublingual dermoid cyst in an infant: a case report and review of the literature.Clin Case Rep. 2020; 8: 1403-1408Crossref PubMed Scopus (1) Google Scholar,2Puricelli E Barreiro BOB Quevedo AS Ponzoni D Occurrence of dermoid cyst in the floor of the mouth: the importance of differential diagnosis in pediatric patients.J Appl Oral Sci. 2017; 25: 341-345Crossref PubMed Scopus (12) Google Scholar Some large cysts may cause respiratory discomfort as well as swallowing and speech impairment.3Oluleke OO Akau KS Godwin AI Kene AI Sunday AO Sublingual dermoid cyst: review of 14 cases.Ann Maxillofac Surg. 2020; 10: 279-283Crossref PubMed Scopus (3) Google Scholar Surgical excision is the treatment of choice via intraoral or extraoral approaches.1Velez-Cruz ME Gomez-Clavel JF Liceaga-Escalera CJ et al.Sublingual dermoid cyst in an infant: a case report and review of the literature.Clin Case Rep. 2020; 8: 1403-1408Crossref PubMed Scopus (1) Google Scholar