Department of Oral Pathology, Microbiology and Forensic Odontology, Maulana Azad Institute of Dental Sciences, New Delhi, India.
Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.
Indian J Pathol Microbiol. 2023 Jul-Sep;66(3):568-572. doi: 10.4103/ijpm.ijpm_1193_21.
Epidermoid cysts (ECs) are uncommon benign cystic lesions derived from the germinative epithelium. Head and neck ECs constitute only 7% of all ECs whereas only 1.6% are seen intraorally. The floor of the mouth is the commonest intraoral site whereas tongue, lips, buccal mucosa, and jaws are less commonly involved intraoral sites. To date, very few large case series of ECs of head and neck have been published. To the best of our knowledge, this is the third-largest case series of 11 intraoral ECs along with 2 extra-oral cases in the pre-auricular region.
To highlight the typical and atypical features of ECs in the common as well as rare sites and draw attention to its consideration as a differential diagnosis for head and neck masses.
Archival data of 13 histopathological cases identified as ECs were analyzed from the Department of Oral Pathology at a tertiary dental hospital and college in New Delhi from 2007 to 2020.
The demographic, clinical, radiographic, histopathological features, and treatment modalities were recorded and analyzed.
Appropriate statistical tests were used.
The study found strong male predilection in the ratio of 10:3 with an average age of presentation as 28 years. The pre-auricular region and floor of the mouth were the common sites involved followed by buccal mucosa, lips, and jaws. All patients presented with slowly growing swelling with dysphagia, dyspnea, and dysphonia seen in larger cysts on the floor of the mouth. Microscopically, all cases were lined with stratified squamous epithelium filled with laminated layers of keratin. Two cases showed the presence of melanin. One case showed recurrence even after complete surgical excision.
ECs, though a rare entity, should be considered in differential diagnosis for head and neck masses and require close follow-up due to their potential for malignant transformation.
表皮样囊肿（ECs）是一种源自生发上皮的罕见良性囊性病变。头颈部 ECs 仅占所有 ECs 的 7%，而口腔内仅占 1.6%。口腔内最常见的部位是口底，而舌头、嘴唇、颊粘膜和颌骨则较少见。迄今为止，仅有少数几篇关于头颈部 ECs 的大型病例系列报道。据我们所知，这是第三大口腔内 ECs 病例系列，包括 11 例口腔内病例和 2 例耳前区病例。
强调 ECs 在常见和罕见部位的典型和非典型特征，并提请注意将其作为头颈部肿块的鉴别诊断。
从新德里的一家三级牙科医院和学院的口腔病理学系分析了 2007 年至 2020 年期间 13 例经组织病理学证实为 ECs 的病例的档案数据。
记录和分析了人口统计学、临床、影像学、组织病理学特征和治疗方式。
使用了适当的统计检验。
研究发现，男性患病率较高，男女比例为 10:3，平均发病年龄为 28 岁。耳前区和口底是常见的受累部位，其次是颊粘膜、嘴唇和颌骨。所有患者均表现为缓慢生长的肿胀，口底较大的囊肿可出现吞咽困难、呼吸困难和声音嘶哑。显微镜下，所有病例均由复层鳞状上皮覆盖，充满角化的层状结构。有 2 例病例存在黑色素。有 1 例病例即使在完全手术切除后仍有复发。
ECs 虽然是一种罕见的实体，但在头颈部肿块的鉴别诊断中应予以考虑，由于其恶性转化的潜力，需要密切随访。
