Retroauricular epidermal inclusion cyst and submandibular stone
Presentation
Right retro-auricular swelling.
Patient Data
Right inferior retro-auricular subcutaneous cystic lesion just postero-inferior to the right ear lobule with marginal enhancement and a hypodense, non-enhancing homogenous core of near fluid density, suggestive of a sebaceous cyst (epidermoid inclusion cyst).
Bilateral multiple intra-parotid lymph nodes preserved oval shape, homogenous enhancement, and intact outline; the largest is noted at the posterior aspect of the superficial lobe of the right parotid gland, measuring 1.2 x 1.3 x 1.9 cm, likely reactive bilateral intra-parotid lymph nodes.
The left submandibular gland showed a large, dense stone obstructing its main duct at the hilum. It measured 1.5 x 1 x 1.3 cm with mild intraglandular ductal dilatation. This is associated with mild glandular enlargement, in keeping with left submandibular sialolithiasis.
Multiple enlarged upper cervical inflammatory lymph nodes with preserved oval shape, central fatty hilum, homogenous enhancement, and intact outline.
Case Discussion
The submandibular gland is the most common site for sialolithiasis. Here, there is an incidentally impacted stone at the left submandibular gland hilum with mild intraglandular duct dilatation.
The sebaceous cyst (epidermal inclusion cyst) usually appears as a spherical, hypodense fluid-density mass below the skin.
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