This article highlights 2 contrasting lesions of the floor of the mouth, the first being a benign lipoma growth and the latter, an adenoid cystic carcinoma. Both of these lesions appear clinically similar, presenting as a swelling with normal overlying mucosa and otherwise asymptomatic at the time of clinical examination. As the swelling for Case 1 is small and fluctuant, no special investigation was ordered, whereas a computed tomographic scan was ordered for the larger expansile lesion in Case 2. The lesions were excised under local and general anaesthesia respectively and a histology henceforth. Recovery for both cases were uneventful and no recurrence or complication was noted to date when this article was written. The two extreme natures of the lesions manifested in the region serve as a cautionary note to clinicians.
The floor of the mouth takes form as early as in the fourth week of gestation with the downward growth and subsequent degeneration of the ectoderm surrounding the peripheral of the tongue, forming the lingual sulcus separating the tongue and the floor of the mouth. The anterior boundary is demarcated in the sixth week with the formation of the Merkel’s cartilage, which later ossifies to form the mandible.
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