Different Radiologic Appearances of Giant Epidermoid Cysts at the Floor of the Mouth : Three Case Reports

Epidermoid and dermoid cysts are benign lesions which may occur anywhere on the body. Seven per cent of these lesions occur in the head and neck region and 1.6% in the oral cavity. We presented three cases of giant epidermoid cysts located on the floor of the mouth. Case one was a 22-year-old man referred to our clinic with a 10-year history of a submental mass which began growing and causing pain in the throat. Physical examination revealed masses in both the submental and sublingual regions. Magnetic resonance imaging (MRI) with contrast revealed a well-circumscribed iso-hypointense cystic mass with a ‘sack-of-marbles’ appearance. Case 2 involved a 23-year-old female referred to our clinic with difficulty in chewing and swallowing solid food for one week previously. Physical examination revealed a sublingual mass displacing the tongue upward. Magnetic resonance imaging revealed a heterogeneous hyperintense cystic mass in the sublingual region. Case 3 was a 28-year-old man referred to our clinic with submental swelling, difficulty in breathing and swallowing, decreased tongue movements and snoring. Computerized tomography (CT) indicated a homogenous cystic mass in the submental region. Excision of the masses with an extraoral approach was performed in all three cases. Histopathological examination revealed epidermoid cyst. In summary, epidermoid cysts may assume various appearances at radiological imaging.