title: Malignant transformation of a long-standing submental dermoid cyst to a carcinosarcoma: a case report.
abstract: BACKGROUND
  Submental dermoid cysts are uncommon midline cysts which occur due to entrapment of ectoderm between the second and third branchial arches during embryogenesis. Most dermoid cysts of the head and neck are benign, but rarely malignant transformation may occur. To the best of our knowledge, this is the first report of a carcinosarcoma arising in a submental dermoid cyst.
  
  
  METHODS
  A 42-year-old Sri Lankan Tamil man presented with a large cystic swelling in his submental region which was diagnosed as an extensive submental dermoid cyst. The cyst had been asymptomatic for 11 years but there was sudden enlargement and pain during the past 2 months. On surgical removal, a primary carcinosarcoma arising from part of the cyst wall was identified. After completion of radiotherapy, the disease was well controlled and he was disease free at 18 months.
  
  
  CONCLUSIONS
  Although extremely rare, a dermoid cyst of the submental region can undergo malignant transformation. It can be successfully treated with surgical excision and radiotherapy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka. nadeenaj@pdn.ac.lk.
authors.forename: Nadeena Sri Swarnagupta
authors.initials: NS
authors.lastname: Jayasuriya
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Samadarani
authors.initials: S
authors.lastname: Siriwardena
authors.affiliation: Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka.
authors.forename: Wanninayake Mudiyanselage
authors.initials: WM
authors.lastname: Tilakaratne
authors.affiliation: Department of General Pathology, Teaching Hospital, Batticaloa, Sri Lanka.
authors.forename: Suchithra
authors.initials: S
authors.lastname: Parthiepan
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D002296:Carcinosarcoma / Q000150:complications / Q000532:radiotherapy / Q000601:surgery; D002471:Cell Transformation, Neoplastic / Q000473:pathology*; D003131:Combined Modality Therapy; D003884:Dermoid Cyst / Q000150:complications / Q000473:pathology* / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000150:complications / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D016896:Treatment Outcome
keywords: Carcinosarcoma; Case report; Dermoid cyst; Malignant transformation; Submental