A 31-year-old man presented with a 10-year history of a lump on the lower lip. He had been treated by incision and drainage at local clinics twice before visiting us, but the lesion had gradually enlarged again in recent years. Otherwise he had no notable past or family history. Physical examination of the lower lip revealed a 3×3 cm-sized soft, palpable cystic mass (Fig. 1A). There was no sign of cervical lymphadenopathy. A punch biopsy was taken from the center of the lesion.
Fig. 1. (A) A 3 x 3 cm-sized soft, palpable cystic mass on the lower lip. (B) Intraoperative findings of an intraoral approach showing connection of cystic wall with the dermal portion of the mentolabial fold below the lower lip. (C) Postoperative finding after complete excision. (D) Partially-excised skin on the mentolabial fold after removing the connected cystic wall completely.
On histopathologic examination, the specimen showed keratin materials and numerous multinucleated, giant cells under the mucosal layer, representing a foreign body reaction. The wall of the cystic lesion was composed of several layers of squamous cells including a granular layer. These findings were consistent with those of an epidermal cyst. We planned complete excision of this lesion by an intraoral approach for postoperative cosmetic results. Intraoperative findings showed a well-demarcated cystic mass, and the base of the cyst was connected by a dermal portion of mentolabial fold below the lower lip (Fig. IB, D). We completely excised the cyst with the connected portion of mentolabial skin gap (Fig. 1С, D), and histologically confirmed an epidermal cyst (Fig. 2). No evidence of recurrence was observed for one year. canadian pharmacy cialis
Fig. 2. The excised cyst demonstrated that is lined by stratified squamous epithelium with a granular layer and is filled with laminated keratin.