Sublingual Gland Herniation Masquerading as Submandibular Lesion

Most defects of the mylohyoid muscle are less than 5 mm, but occasionally they may be larger than 2 cm. Therefore, larger herniations may be mistaken both clinically and radiologically for pathologic abnormalities. We report a case of sublingual gland herniation through the defect of the mylohyoid muscle masquerading as submandibular lesion. A 72-year-old female was referred to our department with a painless swelling in the left submandibular region. The elastic hard mass was mobile in the bimanual palpation. The mucosa of the oral floor was normal. Computed tomography showed a well-circumscribed, homogeneous lesion in the left submandibular region. Because the lesion was diagnosed radiologically as a sublingual gland herniation through the defect of the mylohyoid muscle, surgical treatment was not required. Recognition of mylohyoid muscle defect and the typical radiologic appearance of sublingual gland herniation can allow differentiation from other pathologic lesions and prevent unnecessary surgery.