Massive Dermoid Cyst of the Floor of the Mouth - A Case Report

Rationale: Dermoid cysts of the floor of the mouth are rare benign developmental lesions that typically present in young individuals. Patient Concern: We report a 17-year-old male with a long-standing submental and intraoral swelling associated with dysphagia, dysarthria, snoring and positional breathing difficulty. Clinical examination revealed a large midline cystic mass elevating and deviating the tongue, with bilateral submental extension. Airway narrowing was evident on endoscopic evaluation. Diagnosis: Histopathological analysis confirmed a dermoid cyst. Treatment: Due to the size of the lesion and anticipated airway compromise, a prophylactic tracheostomy was performed prior to complete surgical excision via an extra-oral approach. Outcome: The post-operative course was uneventful, with complete resolution of symptoms. Takeaway Lessons: This case highlights the importance of early diagnosis, airway planning and appropriate surgical approach in the management of massive dermoid cysts.