A 30-year-old male who came to our service in 1999 with a submental tumor of progressive growth of year and half of evolution that did not associate dysphagia or dyspnea.
Among the personal history, it is worth noting only the diagnosis of congenital pyloric stenosis and that the patient was a smoker of 20 cigarettes a day.
On physical examination, we found a submental tumor centered more than 5 cm in diameter, of elastic consistency, adhered to, simulating a double mental image.
1.
Ultrasound showed a hypoechogenic mass with anechoic areas and posterior acoustic enhancement, compatible with thyroglossal duct cyst and dermoid cyst.
Needle aspiration biopsy (FNAC) revealed abundant scaly cells.
To better understand the anatomical relationships of the tumor, a computed tomography (CT) was requested, in which a suprahyoid cystic image was observed in the submental space of 5.5 × 4 × 7.5 cm, well-defined, encapsulated.
Given the large size of the cyst, surgical treatment was performed by cervicotomy under general anesthesia, with suprahyoid horizontal incision, developing a subplatismal flap.
The cyst was above the plane of the mylohyoid muscle (oral side), which was distended by the tumor.
After completing the dissection following the plane of the cyst capsule and achieving its excision, we placed a Jackson-Pratt drain.
The patient was discharged two days later and the evolution was favorable.
In the anatomopathological report, we found macroscopically a lobulated cystic formation of a soft layered surface, nodular forms of uniform texture, and low lipid content inside.
Microscopically, a cyst with scaly coating and keratin inside, chronic inflammation of the wall with granulomatous reaction to foreign body, without glandular structures or parenchyma is observed.
