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<p>Epidermoid cysts and schwannomas are rare benign lesions in the oral cavity that may present with overlapping clinical features, thereby posing diagnostic challenges. This case series highlights two uncommon entities involving the floor of the mouth.</p><p>The first case involved a 65-year-old female with a painless, progressively enlarging sublingual swelling, leading to speech impairment. Imaging revealed a well-defined encapsulated lesion with cystic changes and mild diffusion. Surgical excision via a tongue-splitting intraoral approach was performed, and histopathology confirmed a schwannoma, predominantly Antoni A type with Verocay bodies.</p><p>The second case was of a middle-aged patient with altered speech and dysphagia. Examination revealed a soft to firm, non-inflammatory, non-compressible swelling of the floor of the mouth. Imaging demonstrated a dumbbell-shaped cystic lesion. Complete surgical excision was performed using the tongue-splitting technique, and histopathological analysis confirmed an epidermoid cyst characterised by keratinised squamous epithelium and keratinous debris. Both patients had uneventful post-operative recoveries with no recurrence noted during follow-up.</p><p>Conclusion: These cases underscore the importance of thorough clinical, radiological, and histopathological correlation in the differential diagnosis of sublingual swellings. A tongue-splitting intraoral approach proved effective in achieving complete tumour removal while preserving function.</p>

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A Giant Cyst and an Uncommon Tumour of the Floor of Mouth: Two Intriguing Case Reports with Diagnostic Dilemmas

  • 期刊论文

  • 发表日期：

    2025年12月22日

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  • K. V. Arunkumar,
  • Shayan Ghosh,
  • Aayushi Chirania,
  • Snehil Shrivastava,
  • Kajol Mahapatra

摘要

Epidermoid cysts and schwannomas are rare benign lesions in the oral cavity that may present with overlapping clinical features, thereby posing diagnostic challenges. This case series highlights two uncommon entities involving the floor of the mouth.

The first case involved a 65-year-old female with a painless, progressively enlarging sublingual swelling, leading to speech impairment. Imaging revealed a well-defined encapsulated lesion with cystic changes and mild diffusion. Surgical excision via a tongue-splitting intraoral approach was performed, and histopathology confirmed a schwannoma, predominantly Antoni A type with Verocay bodies.

The second case was of a middle-aged patient with altered speech and dysphagia. Examination revealed a soft to firm, non-inflammatory, non-compressible swelling of the floor of the mouth. Imaging demonstrated a dumbbell-shaped cystic lesion. Complete surgical excision was performed using the tongue-splitting technique, and histopathological analysis confirmed an epidermoid cyst characterised by keratinised squamous epithelium and keratinous debris. Both patients had uneventful post-operative recoveries with no recurrence noted during follow-up.

Conclusion: These cases underscore the importance of thorough clinical, radiological, and histopathological correlation in the differential diagnosis of sublingual swellings. A tongue-splitting intraoral approach proved effective in achieving complete tumour removal while preserving function.