PDF(Pubmed)
Abstract：
Epidermoid cysts rarely present in the submandibular area, constituting approximately less than 7% of all cystic lesions in the head and neck region and less than 0.01% of all oral cavity cysts. Therefore, epidermoid cysts can be easily misdiagnosed, as the differential diagnosis for a submandibular area mass is very broad. Imaging can help define characteristics of the mass; however, a pathologic specimen is usually required for the final diagnosis. Surgical excision is often required and tolerated well by most patients. However, there is a risk of recurrence of the cyst after excision, as well as a rare chance for malignant transformation if not excised, which must be discussed with the patient at the time of diagnosis of epidermoid cyst. We present a 33-year-old Caucasian female with a left submandibular cystic mass measuring 4.7 cm x 2.9 cm, that was originally thought to be a plunging ranula and subsequently diagnosed as an epidermoid cyst. This report is meant to raise awareness of the possibility of a submandibular mass being an epidermoid cyst as well as appropriate workup, treatment, and prognosis of epidermoid cysts in the submandibular region. This report also describes a unique approach to a submandibular epidermoid cyst of which the submandibular gland is divided for access to the cyst for safe and effective excision. To the author\'s knowledge, this surgical approach has not been described in the literature for a submandibular epidermoid cyst.
摘要：
表皮样囊肿很少出现在下颌下区域，约占头颈部所有囊性病变的7％以下，占所有口腔囊肿的0.01％以下。因此,表皮样囊肿容易误诊,因为下颌下区肿块的鉴别诊断非常广泛。成像可以帮助定义肿块的特征；然而，最终诊断通常需要病理样本。大多数患者通常需要手术切除并且耐受良好。然而,切除后囊肿有复发的风险，以及如果不切除恶性转化的罕见机会，在诊断表皮样囊肿时必须与患者讨论。我们介绍了一名33岁的白人女性，其左下颌下囊性肿块大小为4.7厘米x2.9厘米，最初被认为是一个暴跌的ranula，后来被诊断为表皮样囊肿。本报告旨在提高人们对下颌下肿块是表皮样囊肿的可能性以及适当的检查的认识，治疗,颌下区表皮样囊肿的预后。该报告还描述了一种针对下颌下表皮样囊肿的独特方法，其中下颌下腺被划分为进入囊肿以进行安全有效的切除。据作者所知,这种手术方法尚未在文献中描述用于下颌下表皮样囊肿。
