PMC7452625_01
At the first visit to our department, the imaging findings revealed an elevated alar base, Gerber protrusion and swelling below the mucosa of the left upper lip (white arrows).. (A) Lateral view.. (B) Intranasal view.. (C) Intraoral view.
gr1.jpg
PMC7452625_01_gr1.jpg
fig0005
In the oral cavity, a smooth surface and clear boundary were observed under the left upper lip mucosa (Fig. 1A-C).
(A) Panoramic radiography did not reveal abnormal findings.. (B) Ultrasonography revealed a clearly defined 30-mm lesion with more hypoechoic bands.. (C) Axial brain magnetic resonance imaging (T2-weighted image) revealed a 30-mm lesion located below the orbicularis oris of the left upper lip (white arrow).
gr2.jpg
PMC7452625_01_gr2.jpg
fig0010
A panoramic radiograph revealed no abnormal findings (Fig. 2A). Ultrasonography showed a clearly defined 30-mm lesion with more hypoechoic bands (Fig. 2B), and posterior enhancement and a fine echogenic spot were observed within the lesion. In addition, the lesion exhibited a homogeneous high-signal intensity on T2-weighted imaging and short TI inversion recovery (Fig. 2C).
Intraoperative findings.. (A) The mucous membrane was incised just above the lesion in the oral cavity.. (B) The resected specimen was yellowish-white in color, and its size was about 30 x 25 x 10 mm. The cystic lesion contained a white, cheesy material.
gr3.jpg
PMC7452625_01_gr3.jpg
fig0015
The mucous membrane was incised just above the lesion intraorally, and the lesion capsule was removed without the surround tissues (Fig. 3A). The cystic lesion contained a white, cheesy material (Fig. 3B).
Histopathological findings.. (A) The cystic cavity was lined by an orthokeratinised stratified squamous epithelium (A: haematoxylin and eosin staining, x4).. (B) The connective tissue wall had nerve and smooth muscle tissues. However, no skin appendages were observed (B: haematoxylin and eosin staining, x40).
gr4.jpg
PMC7452625_01_gr4.jpg
fig0020
Based on the clinical and histopathological findings, a diagnosis of epidermoid cyst was made (Fig. 4A, B).
Image of the facial appearance and oral cavity 1 year after surgery.. (A) Lateral view.. (B) Intraoral view.
gr5.jpg
PMC7452625_01_gr5.jpg
fig0025
Swelling of the left upper lip, nasal deformity and Gerber protrusion significantly improved after surgery, and no recurrence was observed after 1 year of follow-up (Fig. 5A, B).