The place of fine-needle aspiration in the preoperative diagnosis of the congenital sublingual teratoid cyst.

The term "teratoid cyst" was first used by Meyer in his classification of dysontogenetic cysts of the cervicofacial region, which was based on the type of germinative layers included in the cyst wall. Sublingual location of a dermoid cyst is not common, with an incidence of 1.6%. The teratoid cyst is the least common, accounting for 1.8% of sublingual dermoid cysts, and such lesions are extremely rare in infancy. In our case, a 7-mo-old male infant was referred with a sublingual mass. Ultrasonography yielded a cystic mass with internal echoes but no specific diagnosis. The smears obtained from fine-needle aspiration (FNA) displayed sheets of large, benign-appearing, anucleated and nucleated squamous cells. There were a number of neutrophils, which had no significant importance. No atypical cells were observed. According to the clinical picture and FNA findings, it appeared to be a cystic structure of keratogenous origin and could have been any type of dermoid cyst. The cyst was excised completely by the oral approach. On histopathological examination, the presence of skin appendages along with mature cartilage and respiratory epithelium confirmed the final diagnosis of a teratoid cyst. In conclusion, although FNA is not comparable with computed tomography (CT) and magnetic resonance imaging (MRI), it might be valuable for the diagnosis of lesions occurring in this anatomical location. It is safe, cost-effective, and reliable. FNA is not only able to help selecting the most appropriate surgical method, but also be used as a therapeutic modality in some emergencies or during surgery. Copyright 2003 Wiley-Liss, Inc.