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Sublingual epidermoid cysts are uncommon. Shore1 stated that only 4 have been observed in 54,000 surgical specimens examined in the pathologic laboratory of St. Luke's Hospital, New York, during the past forty years. The case here reported is of interest not only because of the infrequency with which the condition is encountered but also because during a period of thirty years a correct diagnosis was not made. REPORT OF A CASEJ. D., a white man aged 48, a farmer, was admitted to the United States Veterans Administration Hospital on Oct. 12, 1938, with a diagnosis of "hypertrophy of the left sublingual gland." The history revealed that in 1936 two cervical vertebrae were fractured as the result of an injury.At the age of 18 (thirty years ago) the patient became aware of a small sublingual mass on the left side. It did not give rise to symptoms but appeared to increase in size gradually. By 1926 the mass had enlarged to such an extent that there was difficulty in swallowing. His family physician made a sublingual incision and evacuated a large quantity of foul yellowish sticky material. Within a year the mass had again become enlarged to its original size and was now presenting externally in the left submaxillary region. From 1926 to 1938 the patient was subjected to six external surgical operations, each of which evidently consisted of simple incision and drainage. After each operation the mass recurred.General physical examination and laboratory studies of the blood, urine and sputum indicated no significant deviations from the normal. On examination of the mouth a mass was noted beneath the left half of the tongue. It was approximately the size of a large walnut. On bimanual examination it felt rather "doughy." The mucous membrane covering the mass was normal in appearance. No salivary calculi could be detected by palpation.Externally the neck presented two scars, the residuals of previous operations. One small cicatrix, about 1 cm. long, was noted in the midline above the hyoid bone, while another scar, 4 cm. long, was found parallel to the ramus of the mandible, over the left submaxillary gland.Roentgen ray studies failed to show the presence of calculi or other opaque bodies.A fine probe was easily passed into the submaxillary duct without encountering any obstruction. It was then decided to incise the mucous membrane over the mass in order to determine its nature and extent. Anesthesia was obtained by placing a small pledget of cotton, moistened with 2 per cent pontocaine hydrochloride solution, over the mass under the tongue. The overlying mucous membrane, in addition, was infiltrated with a 2 per cent solution of procaine hydrochloride The United States Veterans Administration does not assume responsibility for statements made or opinions expressed herein.

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