Of all the epidermoid cysts encountered throughout the body, only 7% occurs in the head and neck area, with the oral cavity accounting for only 1.6%. Intraorally this benign slow growing and painless entity is usually located in the submandibular, sublingual and submental region. They can cause symptoms of dysphagia and dyspnoea and have a malignant transformation potential. Surgical excision is the treatment of choice. Described here is a case of gigantic sublingual epidermoid cyst.
A 65-year-old female of Indian origin visited the Out Paitent Department of M.R. Ambedkar dental college, Bangalore (India) in the year 2007 with a complaint of a growth in her lower jaw front teeth region since four months. It started as a small growth which gradually increased to the present size and the patient had no other associated symptoms like pain, difficulty in chewing, speech or deglutition. No treatment was taken for the same. She also noticed a swelling in the neck two months prior to the onset of the intra oral swelling and was also not associated with any symptoms of that or any other similar lesions anywhere in the body [Table/ Fig-1].On general examination a solitary swelling was found on left side of the neck, approximately measuring about 2cm in diameter. Its borders were not well demarcated. Inferiorly it was 3cm above the clavicle, medially about 4cm away from the midline and superiorly it up extended to the level of the thyroid cartilage. Skin over the swelling appeared to be normal. On palpation inspectory findings were confirmed. There was no local rise of temperature. It was soft in consistency, non-tender and skin over the swelling was pinch able. Lymph node examination revealed sub mental and right submandibular lymph nodes palpable, about 0.5cm diameter, firm, fixed and non tender.
Nevus of Ota, a benign melanocytic pigmentary disorder with rare malignant transformation potential, affects 0.014-0.034% of the Asian and Black population and has a strong predilection for females. It occurs in the area innervated by the first and second division of the trigeminal nerve. Oral manifestation is rarely noted with only 14 cases reported till date. This report documents a case of Nevus of Ota with the infrequently noted oral involvement, in an Indian lady. Since oral manifestation is not acknowledged in Tanino's classification, the authors propose a modification to the same.
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