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

[Consistency rates of clinical and histopathologic diagnoses of mucocutaneous lesions in oral cavity]

Many mucocutaneous lesions of the oral cavity have similar clinical features and therefore the histpathologic findings are very important in correct diagnosis and differential diagnosis of each lesion. The aim of this study was to assess the agreement between clinical and histopathologic diagnoses in mucocutaneous lesions of the oral cavity during 30 years [1979-2009] in Mashhad dental School. In this retrospective study, a total of 334 patients with mucocutaneus lesions were analyzed in Mashhad dental school from1979 to 2009. Patient's data including age, gender, location, clinical diagnosis and histopathologic diagnosis were recorded. Data were analyzed through SPSS 11.5 Software. In this study, there was an agreement between clinical and histopathologic diagnoses in 295 subjects [77.5%] with oral mucocutaneus lesions. All subjects with pemphigoid and white spongy nevus showed total agreement between clinical and histopathologic diagnoses. Atrophic and pigmenteted lichen planus also showed the highest percentage of agreement in lichen planus groups. In mucocutaneous lesions, clinical, radiographic, and histopathologic findings are necessary for definitive diagnosis of mucocutaneous lesions