Epidermoid/Dermoid cysts mimicking odontogenic infections: review of literature

Introduction: Dermoid/Epidermoid cysts are rare pathologic lesions that may involve the floor of the mouth. Infection and inflammation of the cyst can produce a clinical picture very similar to the submandibular and submental abscesses with odontogenic origin. Dermoid/epidermoid cysts are on the floor of the mouth with submental or submandibular component can be mistaken for odontogenic infections

Methods: Four biopsy proven dermoid/epidermoid cysts operated in the Mashhad University of Medical Sciences, Ghaem hospital [2012-2013], were reviewed

Results: Four patients, including two classic cases and two infected dermoid/epidermoid cysts, were erroneously diagnosed as odontogenic infection

Discussion: The lesions located solely below mylohyoid muscle need to be removed through anextraoral approach but the lesions above the mylohyoid muscle or those that have both supra- and infra-mylohyoid components can be removed through an intraoral incision

Conclusion: Dermoid/epidermoid cysts should be considered in the differential diagnosis of submental/submandibular swellings. In the absence of an odontogenic cause of infection, fine-needle aspiration biopsy and appropriate imaging evaluation techniques with sonography, CT or MRI are mandatory for correct diagnosis and surgical treatment planning. The clinicians should be very cautious to differentiate odontogenic infections from infected dermoid/epidermoid cysts

Central odontogenic fibroma of the mandible

A 16-years-old female patient with painless swelling of the right side of mandible is described. She noticed the swelling from two years ago, without painful symptoms. Axial CT imaging showed buccal expansion with intact buccal and lingual cortical bone. The report of incisional biopsy was central odontogenic fibroma. Under general anesthesia the lesion was removed after ostectomy of buccal cortical plate and inferior alveolar nerve preserved. Three-year follow-up after tumor excision relieved no recurrence

Calcifying odontogenic cyst with complex odontoma: histological and immunohistochemical features

The calcifying odontogenic cyst [COC] is a rare odontogenic cyst. Only 2% of all odontogenic cysts and tumors are COC. COC associated with odontoma [COCaO] reported in 24% of COCs. COCaO presents a greater incidence in female, with a ratio of 2 to 1. The highest incidence of COCaO occurs during the second decade with a mean age of 16 years, most frequently occurring in the maxilla [61.5%]. Here, we describe a classic case of COCaO of the maxillary incisor-canine region in 17-year-old girl, and discuss the clinicopathological features and immunohistochemical finding of this tumor