Dermoid vs epidermoid cyst / histopathology, clinical and treatment

Dermoid Cyst

A cyst of the midline of the upper neck of the anterior floor of the mouth of young patients derived from remnants of embryonic skin consisting of a lumen lined by a keratinizing stratified squamous epithelium and containing one or more skin appendages such as hair, sweat, or sebaceous glands.

• It is an example of cystic teratoma
• Derived from germinal epithelium entrapped during embryonic development

Clinical features

• It is present in young adults
• Present in the upper neck or floor of the mouth
• Present as painless swelling
• It has doughy consistency
• It is 2cm or less in diameter
  

Histopathological features

• The lining is orthokeratinized squamous epithelium.
• Exhibiting a variable number of dermal appendages such as hair follicles sebaceous glands and erector pili muscles.
• Lumen is filled with desquamated keratin sebum and hair shafts.
• There is a sorrounding zone of compressed connective tissue.
• Generally free of inflammation.
  

Epidermoid cyst

• Same as dermoid cyst but skin appendages are absent.
• Treatment is surgical enucleation. 

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