A woman in her 30s presented with a 1-year medical history of a painless, slowly enlarging, midline neck mass without associated dysphagia, odynophagia, weight loss, or history of infection. The mass was soft, mobile, and compressible in midline level IA, measuring 7 cm and posterior-superiorly displacing the tongue. The mass was visible as a clear blue lesion in the floor of the mouth and was nontender. Computed tomographic (CT) scan of the neck with IV contrast was performed (Figure). The patient was taken to the operating room for a successful combined intraoral and transcervical approach to excision.
Diagnosis
B. Epidermoid cyst
DiscussionEpidermoid cysts (ECs) are classically small, benign, cystic masses with 32% of lesions occurring in the head and neck. 1 They usually arise because of failure of primitive epithelial cells to separate from underlying deep tissue during branchial arch formation. 2 True ECs are fluid-filled lesions lined by simple squamous epithelium and a layer of keratin. They have been referred to by other terms such as epidermal cysts, epidermal inclusion cysts, sebaceous cysts, and seborrheic cysts. However, the terms "seborrheic cysts" and "sebaceous cysts" are misnomers, not synonymous with epidermoid cysts. Epidermoid cysts are normally close to the skin and can be located anywhere on the face, scalp, and neck. However, in the deep tissue planes, ECs in the head and neck make up only 1.6% to 6.9% of cases in the entire body. 3
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.