Unmasking the Impostor: Diagnostic Challenges in a Giant Submental Cyst
Keywords:
Sub mental cyst, Ranula, Sebaceous cyst, Head and neckAbstract
Sebaceous cysts in the oral cavity represent rare developmental anomalies that often pose significant diagnostic challenges due to their clinical and radiological resemblance to other cystic masses such as ranulas and salivary gland tumors. This report details the case of a 40year-old female presenting with a longstanding, painless swelling in the submental region, initially suspected to be a plunging ranula based on ultrasonography and computed tomography findings. Surgical excision was performed via an extraoral approach, and subsequent histopathological evaluation revealed features diagnostic of a sebaceous cyst rather than a ranula. This case underscores the importance of thorough clinical, radiological, and histopathological evaluation in differentiating among cystic lesions of the floor of the mouth, as misdiagnosis may lead to inappropriate management and increased morbidity. Complete surgical excision remains the definitive treatment, with an excellent prognosis upon accurate preoperative diagnosis. Clinicians should maintain a broad differential when evaluating midline cystic lesions in this region.
References
1. Cunha JLS, de Souza LN, Soares MSM, de Carvalho PSP, Gomes CC, Goulart EMA. Clinicopathologic analysis of oral dermoid and epidermoid cysts. Braz Oral Res. 2023;37:e089.
2. A giant dermoid cyst in the floor of the mouth: a case report. Int J Otorhinolaryngol Head Neck Surg. 2024;10(2):482-5.
3. Brunet-Garcia A, et al. Cystic mass of the floor of the mouth. World J Clin Cases. 2018;6(9):299-305.
4. Sharma N, Gupta R, Mehta R, Verma S. Clinical and radiological evaluation of dermoid cysts in the oral cavity: MRI superiority in assessment. J Oral Med Surg. 2022;3(1):45-50.
5. Chen P, Wang L, Xu Y, Li J. Differentiation of ranula and dermoid cyst: ultrasonography and CT comparison. BMC Oral Health. 2020;20:161.
6. Kumar M, Goel R, Sinha V, Singh S. Dermoid cysts and management challenges in the head and neck region. Indian J Otolaryngol Head Neck Surg. 2018;70(2):240-4.
7. Lee JH, Kim MG, Park HY, Boo SH, Kim KH. Surgical approaches for cystic lesions of the floor of mouth: a case series and review. J Craniofac Surg. 2016;27(5):1244-7.
