JAPANESE JOURNAL OF ORAL & MAXILLOFACIAL SURGERY

Vol. 55 No. 2       2009

ISSN: 0021-5163      UBIC: 151-J

ABSTRACT

We report a case of giant sublingual epidermoid cyst extending bilaterally to the submandibular region because of an anomaly of the digastric muscle. A 29-year-old man was referred to our clinic because of a painless swelling in the left submandibular region. Magnetic resonance imaging revealed a well-defined dumbbell-like mass that extended bilaterally from the sublingual area to the submandibular region. Signal density of the mass was homogeneously intermediate on both T1- and T2-weighted images. The lesion was extraorally extirpated with the patient under general anesthesia. The mass was located inferiorly to the geniohyoid muscle and superiorly to the mylohyoid and digastric muscles. Its central portion was constricted by the aberrant anterior bellies of the digastric muscle. The extirpated mass was an 11.5 X 6.0 X 2.5 cm well-encapsulated cyst containing yellowishbrown paste. It was identified to be an epidermoid cyst on histopathological examination. The postoperative course has been uneventful, without recurrence for about 11 months. Since 1957, 11 cases of giant dermoid or epidermoid cyst more than 5 cm in diameter have been reported in Japan. Our case is the biggest epidermoid cyst so far, and the aberrant shape seemed to be caused by the anomaly of the anterior belly of the digastric muscle. Keywords: anomaly, digastric muscle, epidermoid cyst, submandibular region.

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