TREATMENT OF SUBMANDIBULAR EPIDERMAL INCLUSION CYST: CASE REPORT

Abstract

Introduction: Epidermal inclusion cyst, also known as epidermoid cyst, is a benign lesion of ectodermal origin, characterized by slow, painless and asymptomatic growth. Although it is more common in regions such as the scalp, face and trunk, its occurrence in the submandibular region is rare. These cysts are formed by the proliferation of epidermal cells within the dermis, often associated with trauma, chronic irritation or implantation of epidermal cells. Diagnosis is usually made through clinical and imaging exams, such as ultrasound, computed tomography or magnetic resonance imaging. Standard treatment involves complete surgical excision of the lesion, ensuring total removal of the cystic capsule to prevent recurrence. Methodology: This literature review was carried out based on scientific articles arranged in the MEDLINE databases via PubMed (Medical Literature Analysis and Retrieval System Online), LILACS (Latin American and Caribbean Literature in Health Sciences) and Virtual Health Library (BVS). The inclusion criteria for studies were articles that were within the thematic approach, available in full and free of charge, in English, Portuguese and Spanish. Duplicate articles and those that deviated from the central theme of the research were excluded. Results: Complete surgical excision of the cyst, including the capsule, remains the treatment of choice for most cases of submandibular epidermal inclusion cyst. The open surgical approach, with an incision in the submandibular region, allows direct visualization and complete removal of the lesion, minimizing the risk of recurrence. However, this technique can result in visible scars and increased postoperative morbidity. In selected cases, minimally invasive techniques, such as punch excision or marsupialization, can be considered. Punch excision involves incision of the skin over the cyst and removal of the cystic content, followed by curettage of the capsule. Marsupialization, in turn, consists of opening the cyst and suturing the edges of the capsule to the skin, allowing continuous drainage of the cystic content. These techniques have advantages such as reduced morbidity, smaller scars and faster recovery, but may be associated with a higher risk of recurrence. The choice of surgical technique depends on several factors, including the size and location of the cyst, the presence of infection or inflammation, the surgeon's experience and the patient's preferences. Careful preoperative evaluation, including imaging tests such as ultrasound or computed tomography, is essential for adequate surgical planning and identification of possible complications. Conclusion: The treatment of submandibular epidermal inclusion cysts should be individualized, considering the specific characteristics of each case. Complete surgical excision remains the treatment of choice, especially in cases of large, infected or recurrent cysts. Minimally invasive techniques can be considered in selected cases, offering advantages such as reduced morbidity and faster recovery. Multidisciplinary collaboration between head and neck surgeons, plastic surgeons and dermatologists is essential to ensure the best aesthetic and functional result for the patient.