Pediatric Sublingual Dermoid Cyst: Diagnostic Challenges and Surgical Management in a 13-Year-Old Boy

BACKGROUND Ranulas are typical causes of sublingual cysts in children. However, our case was histopathologically confirmed to be a dermoid cyst. Epidermoid and dermoid cysts of the floor of the mouth account for <0.01% of all oral cavity lesions and 0.29% of head and neck tumors in children. Salivary congestive cysts (ranulas) involve the sublingual salivary glands or the common duct of the sublingual and submandibular salivary glands. This report describes a 13-year-old boy presenting with a sublingual cyst, diagnosed by histopathology as a dermoid cyst. Treatment is based on surgical removal of the cyst, sometimes along with the altered salivary gland. CASE REPORT A 13-year-old boy was admitted to the Department of Otolaryngology with the Subdivision of Maxillofacial Surgery for the diagnosis of a tumor localized under the tongue. A significant growth of the tumor during a 3-month period was noticed, with appearance of a mass effect, speech disorders, and difficulties in eating. Significant elevation of the floor of the mouth and tongue was shown. The presence a ranula was indicated. Surgical excision was performed using intra-oral excision. Histopathological examination revealed a diagnosis of dermatoid cyst. CONCLUSIONS This case highlights the importance of detailed histopathological diagnosis of lesions and the usefulness of imaging methods like magnetic resonance imaging (MRI), ultrasound (US) or computed tomography (CT). Our patient had a dermoid cyst, which appears rarely among children in the floor of the mouth. This shows the significance of their proper differentiation, as some may be misdiagnosed as ranula.