Epidermoid Cyst of Mandible Ramus: Case Report

Abstract

Introduction:An epidermoid cyst is a benign cyst usually found on the skin. Bone cysts are very rare and if they appear in bone they usually appear in the distal phalanges of the fingers. Epidermoid cysts of the jaws are uncommon.Case presentation:We present a case, of a 41 year-old female patient admitted to our department because of pain and swelling in the parotid and masseteric region–left side. There was no trismus, pathological findings in skin, high body temperature level, infra-alveolar nerves anesthesia or lymphadenopathy present. The orthopantomography revealed a cystic lesion and a unilocular lesion that included mandibular ramus on the left side with 3 cm in diameter. Under total anesthesia, a cyst had been reached and was enucleated. Histopathologic findings showed that the pathologic lesion was an epidermoid cyst.Discussion:Epidermoid and dermoid cysts are rare, benign lesions found throughout the body. Only a few cases in literature describe an intraossesus epidermoid cyst.Conclusion:Our case is an epidermoid cyst with a rare location in the region of the mandibular ramus. It is not associated with any trauma in this region except medical history reveals there was an operative removal of a wisdom tooth 12 years ago in the same side. These cysts are interesting from the etiological point of view. They should be considered in the differential diagnosis of other radiolucent lesions of the jaws. Surgically they have a very good prognosis, and are non-aggressive lesions.

A rare case of giant intradiploeic epidermal cyst of the frontal bone with intracranial extension

“…It is characterized by expansile growth, characterized by thinning of the bone, and can mimic a lytic bone malignancy. [ 5 ] The intradiploeic epidermoid of the skull can attain huge sizes and are primarily extradural. [ 6 ] Our lesion was one among the largest of such lesions reported.…”

Posttraumatic intraosseous epidermoid inclusion cyst. A case report and short literature review

“…The specimen obtained after successful surgical excision was sent to the Pathology They rarely appear in the bones, usually under the form of pseudotumors or small lytic lesions, either in the skull of young patients or in the phalanges of older patients. Also, there are some reports of epidermoid bone cysts of temporomandibular joint, mandible, maxilla, vertebrae, tibia, sacrum and femur [1,3,5,8,9]. Apart from the location in the distal phalanges of the fingers, posttraumatic epidermoid cysts have been reported in only 4 cases involving the great toes [10].…”

“…Most intraosseous epidermoid cysts are solitary lesions, but there are rare cases of patients who presented with cysts affecting multiple fingers of the same hand. It is believed that the appearance of these lesions is secondary to a traumatic event, being caused by the intrusion of epidermal tissue into the bone [1][2][3][4][5]9,11]. Lesions of this kind are relatively easy to diagnose if the patient's personal history is taken into account.…”

“…These lesions commonly occur in males in the third to sixth decades [1,2]. Skull lesions are supposed to be congenital lesions and are more frequently diagnosed in the first decade of life [3]. Those lesions are considered to arise from ectodermal inclusion during neural tube closure and subsequently remain within the cranial bones.…”

Diagnóstico e tratamento de cisto epidermoide: relato de caso

“…(2016) relataram um caso de cisto epidermoide em ramo mandibular após 12 anos da exodontia de um terceiro molar incluso. Nesses casos, pode -se optar pela punção aspirativa por agulha fina para excluir hipótese de lesões mais agressivas, como queratocisto e ameloblastoma (Loxha, et al, 2016;Montebugnoli, et al, 2011). Quando há o envolvimento ósseo, a marsupialização é uma boa opção para descomprimir a lesão e possibilitar a recuperação lenta do tecido ósseo, até que se possa realizar a completa enucleação sem comprometimento de estruturas adjacentes ( (Loxha, et al, 2016).…”