2012 Volume 105 Issue 6 Pages 559-566
We experienced two cases of epidermoid cysts, which were 60-90 mm in diameter with intracystic fat balls inside. The cysts were located in the floor of the oral cavity. A 31-year old male (case 1) suffered from difficulty of swallowing and deviation of the tongue toward the posterior wall of the oropharynx because of the giant cyst. MRI showed a giant cyst of more than 90 mm with a low intensity area in T1 and a high intensity area in T2, involving the spherical structures, in the sublingual space. A 25-year old female (case 2) suffered from the swelling of the floor of the oral cavity and difficulty in breathing when she lay down in the supine position. MRI showed similar findings, compared to case 1. The histopathological diagnosis in both patients was an epidermoid cyst which was treated with surgery. It has been reported that the epidermoid cyst, the dermoid cyst and the teratoid cyst usually occur in the anus and the ovary. It is unusual to find epidermoid and dermoid cysts in the floor of the mouth. When it comes to the surgery, there are two ways to remove the tumor, based on its location. The intraoral approach is chosen for tumors located in the rostral to the suprahyoid muscles. The other is the extraoral approach (skin incision) for the tumor on the muscles. However, the standard method of the surgery for those giant tumors has not been established. The extraoral approach was chosen for the giant cysts in the present study, to avoid leaving any relic of the cyst wall. Recurrence has not been observed for 6 months after the surgery.
