Hulk's Enormous Neck Cyst Removal, Blackhead King Medical Case Report

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Good Medical morning! This is watson and today we are going to look at THIS enormous epidermoid cyst.

Epidermoid cysts are rare, slow‑growing, benign, developmental cysts, which are derived from abnormally situated ectodermal tissue. Epidermoid cysts of the floor of the mouth represent 0.01% of all oral cysts. So far, only a few cases have been reported.

In this case we present a giant sublingual epidermoid, dermoid cyst. The patient doesn't have any particular symptoms, other than those related to its size. Accordingly, the cyst pushed the epiglottis posteriorly and created difficulty during intubation for surgery. Let's look at the scans of the object.

CT scan of the affected area showed a large, well-defined, thick walled, peripherally enhancing cystic lesion measuring 10.3cm x 8.1cm in the midline submandibular region.

Swelling was separate from all surrounding structures. No enlarged lymph nodes were seen. No bony erosion was observed. Neck vessels were normal. Parotid, thyroid, and left submandibular gland were normal... so that's good news. Other than the cyst, the patient's face and neck are somewhat normal.

Let's look at the post surgery images. Click like for the surgeon! (Zoom in and crop the images as needed for more views)

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Histopathological examination revealed a thick walled cyst lined with a stratified squamous epithelium with acidophilic stratum corneum and basophilic dot like staining of stratum granulosum without any evidence of dermal appendages confirming the diagnosis of epidermoid cyst.



Clinically, epidermoid cysts are painless, slow growing lesion with doughy consistency, often soft and well encapsulated without any associated lymphadenopathy.

One of the biggest concerns in a surgery like this is keeping the airway open so the patient can breathe. In this case Tracheostomy was performed and the airway secured. The patient recovered well and successful weaning of tracheostomy was performed later on.





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