Different Radiologic Appearances of Giant Epidermoid Cysts at the Floor of the Mouth: Three Case Reports

ABSTRACT Epidermoid and dermoid cysts are benign lesions, which may occur anywhere on the body. Approximately 7% of these lesions occur in the head and neck region and 1.6% in the oral cavity. We present three cases of giant epidermoid cysts located on the floor of the mouth. Case 1 was a 22-year-old man referred to our clinic with a 10-year history of a submental mass, which began growing and causing pain in the throat. His physical examination revealed masses in both the submental and the sublingual regions. Magnetic resonance imaging (MRI) with contrast revealed a well-circumscribed isohypointense cystic mass with a 'sack of mar- bles' appearance. Case 2 involved a 23-year-old female referred to our clinic with difficulty in chewing and swallowing solid food for 1 week previously. Her physical examination revealed a sublingual mass displacing the tongue upward. Her MRI revealed a heterogeneous hyperin- tense cystic mass in the sublingual region. Case 3 was a 28-year-old man referred to our clinic with submental swelling, difficulty in breathing and swallowing, decreased tongue movements and snoring. His computerized tomography indicated a homogenous cystic mass in the sub- mental region. The excision of the masses with an extraoral approach was performed in all the three cases. His histopathological examination revealed epidermoid cyst. In summary, epider- moid cysts may assume various appearances at radiological imaging.

An Atypical Presentation of Tuberculosis Lymphadenitis

ABSTRACT Tuberculosis (TB), one of the oldest diseases of human, remains a global health problem especially in developing countries. Tuberculosis is classified as pulmonary or extrapulmonary. Tuberculosis lymphadenitis is the most common form of extrapulmonary TB. In this report, we present a patient with TB lymphadenitis who had atypical multiple lymph node involvement similar to malignancies without symptoms of lung disease. An 81-year-old male presented with a 3-month history of a growing swelling in the cervical region. In the month prior to presentation another swelling developed in the right axillary region. Physical examination revealed multiple lymphadenopathies in the cervical and axillary regions. A computerized tomography revealed lymphadenopathy at right axillary region 5 × 2 cm in diameter, a cystic mass or abscess at right posterior cervical region 3 × 2 cm in diameter and multiple lymphadenopathies in the cervical regions. Thoracic tomography revealed fibro-atelectasis, thick fibrotic bands and increased reticulonodular density in both lungs which were reported as reactivation of TB. An excisional biopsy was performed which revealed granulomatous inflammatory process with caseous necrosis. Acid-resistant bacteria were detected from microbiological assessment of both the pus of the mass and the nodular lesion via polymerase chain reaction. The diagnosis was reactivated TB lymphadenitis. Although multiple lymphadenopathies accompanied with weight loss suggest malignancies, TB must also be considered in the differential diagnosis.

Traumatic Displacement of Maxillary Teeth into the Nasal Cavity: A Diagnosis Delayed for 15 Years

ABSTRACT Intrusion is defined as displacement of a tooth into the alveolar bone. In this report, we presented a patient with 15 years of delayed diagnosis of maxillary teeth intrusion into the nasal cavity. A 30-year-old male presented to our clinic with nasal discharge. He had been in a traffic accident 15 years ago. Radiographic examination revealed intrusion of two anterior teeth into the nasal cavity. In patients with maxillofacial trauma, the possibility of having an accompanying dentoalveolar trauma must always be kept in mind. While a computerized tomography (CT) scan is useful in diagnosis of such traumas, it must be performed in all patients with maxillofacial trauma to avoid misdiagnosis.