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British Journal of Oral and Maxillofacial Surgery 46 (2008) 131–132

Short communication
Lateral dermoid cyst
Richard M. Graham a,∗ , Ewen F. Thomson a , Robert T.M. Woodwards a , Philip Sloan b
a Department of Oral and Maxillofacial Surgery, North Manchester General Hospital, Crumpsall M8 5RB, United Kingdom
b Oral Pathology Unit, University Dental Hospital of Manchester, Manchester M15 6FH, United Kingdom

Accepted 29 October 2006

Available online 22 December 2006

Abstract

This is an unusual case of a lateral dermoid cyst that caused some diagnostic confusion.
© 2006 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Keywords: Lateral dermoid cyst; Computed tomogram

A 31-year-old man had, in total, a 17-year history of inter- occur mostly in the midline of the floor of the mouth.2 How-
mittent swelling of the right submandibular triangle and floor ever, it is possible that this was a midline dermoid cyst that
of the mouth. The presentation and ultrasound investigation had migrated laterally by expansion.
suggested sialadenitis of the right submandibular salivary
gland.
The patient was reluctant to attend for regular reviews,
so it was not until during the last 2 years that he presented
with repeated episodes of swelling of this region, caused
by an acute infection that required intravenous antibiotics
and a number of admissions to hospital. Despite the size
of the lesion, he had no functional impairment of swal-
lowing or speech. During one admission, because of the
repeated swelling and questionable initial diagnosis, a com-
puted tomogram (Fig. 1) was done, which showed fluid in
the floor of the mouth lateral to the styloglossal complex
extending to the submandibular salivary gland; the possible
diagnoses were a ranula or cystic hygroma, but the exact
diagnosis was still not clear.
The lesion was excised by a neck dissection. Histopatho-
logical examination confirmed a complex lateral dermoid cyst
that contained epithelium and appendages of skin. Later radi-
ological and histopathological investigations suggested that
the fluid contained a mixture of pus, exudates, and keratin.
Dermoid cysts are thought to comprise about 34% of
developmental cysts in the head and neck region,1 and these
Fig. 1. Axial computed tomogram showing an extensive cystic mass caus-
∗ Corresponding author. Tel.: +44 7977579170. ing compression and displacement of the lobes of the right submandibular
E-mail address: grahamrm@ukonline.co.uk (R.M. Graham). salivary gland.

0266-4356/$ – see front matter © 2006 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
doi:10.1016/j.bjoms.2006.10.015
132 R.M. Graham et al. / British Journal of Oral and Maxillofacial Surgery 46 (2008) 131–132

This case shows that repeated episodes of infection can References

change the presentation and appearance of a well-known
entity such as a dermoid cyst, and that sophisticated investi-
gations may only confound their diagnosis.
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