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MRI of axial view (A) and coronal view (B) demonstrates the left sublingual epidemoid cyst extended posteriorly to the left parapharyngeal space.
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T2-weighted image cystic lesion at the left sublingual space above the mylohyoid muscle that extended to the left submandibular and left parapharyngeal space displacing the left submandibular gland downward (Fig. 1).
Intraoral excision sublingual epidermoid cyst.
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For a better cosmetic result, we chose an intraoral approach with the informed consent of the possibility of conversion to an extraoral approach if the intraoral approach was unsuccessful (Fig. 2).
Surgical specimen.
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The cyst was removed with an intact capsule (Fig. 3).
Histopathology of the cyst revealed benign stratified squamous epithelium-lined cyst with no evidence of adnexal structure consistent with the epidermoid cyst, arrowhead: Keratin material, arrow: Squamous epithelial cell (H&E;100x).
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Histologic examination showed a benign stratified squamous epithelium-lined cyst with no evidence of adnexal structure consistent with the epidermoid cyst (Fig. 4).
Postoperative photo at one month.
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The patient recovered (Fig. 5) and remained disease-free after two years of follow-up.