A rare twist: Malignant transformation of epidermal cysts in the submandibular gland- A case report and literature review

Epidermal inclusion cysts are generally benign lesions, but their potential for malignant transformation is rare. This case report describes two instances of malignant transformation of epidermal cysts in the submandibular gland to squamous cell carcinoma (SCC). Although clinical presentation, cytology, and imaging initially suggested benign epidermal cysts, definitive histopathological examination identified SCC. Complete excision of the cysts was performed, and the patients were subsequently referred to the oncology department for further management. This report emphasizes the rarity of such transformations, with only one prior case documented, and highlights the diagnostic and surgical challenges encountered in these complex scenarios.