## 4 Discussion  
Of the seven cases of oral LECs studied, we note an average of 40 years (Tables 1 and 3) compared to 38 years reported according to the literature (Table 4). Cervical LECs were diagnosed at an average age of 36 years, which is slightly above the literature [8; 12]. The ratio of female:male for oral LECs is 1.33 (four females to three males), according to our cases (Table 3), and 0.9 (255:258) in the literature (Table 4). Though the majority of studies analyzed reveals female predilection [2; 16; 17; 18; 20; 21], one large series of cases from China [4] skewed the general trend, resulting in a slight male predilection. The preferred location of the oral LEC is the tongue and floor of the mouth (Table 4), where three (42%) of our cases occurred, followed by single lesion each at the palate, ventral tongue, and tonsillar fossa. A similar trend was seen in the literature, as well, with respect to oral LEC, with 81% of the total lesions occurring in either the tongue or floor of the mouth (Table 4). The cervical LECs occur in a great majority of cases in the superior anterior triangle of the neck [15] and parotid region [53]. According to [PERSON] et al. [10], they can be found in all the territory arising from the bronchial arches. LECs that arise in the parotid region are unique as they have been shown to be associated with HIV infection and are also described as benign lymphoepithelial lesions (BLEL). However, none of the cases described by [PERSON] et al. [53] were found to harbour HIV or EBV infection. Even so, unlike oral and cervical LEC, similar lesions in the parotid would require investigation to exclude HIV, as the management of such lesions is not purely surgical [54]. Presumptive diagnoses of the seven oral LECs were similar to those in the literature [4]. Considering the rarity of the lesion, none of the oral LECs were clinically diagnosed as such. In addition, bearing in mind the inconspicuous nature of the lesion, an inaccurate clinical diagnosis would not hinder the overall management of oral LEC. Presumptive diagnosis of cervical LEC is similar to that found in the literature as well [13]. Unlike oral LECs, clinicians proposed the diagnosis of bronchial cyst for majority of patients. However, considering that two lesions were clinically suspected as neoplasms and one carried the clinical diagnosis of lymphoma, the chance of over-treatment is higher with cervical LECs \begin{table}
\begin{tabular}{c c c c c c} \hline \hline \multirow{2}{*}{**Reference**} & **Number of Cases** & **Average Age (Years)** & **Gender (F:M)** & \multicolumn{2}{c}{**T/FOM**} & **Other** \\ \hline
2 & 38 & 39 & 15:23 & 26 & 12 \\ \hline
3 & 24 & 36 & 07:17 & 24 & 00 \\ \hline
4 & 120 & 44 & 37:83 & 98 & 22 \\ \hline
16 & 132 & 45.5 & 83:49 & 112 & 20 \\ \hline
17 & 77 & 46.5 & 54:23 & 57 & 20 \\ \hline
18 & 26 & 33 & 14:11 * & 26 & 00 \\ \hline
19 & 24 & 44 & 09:15 & 24 & 00 \\ \hline
20 & 08 & 40 & 05:03 & 07 & 01 \\ \hline
21 & 21 & 32 & 12:09 & 17 & 04 \\ \hline
22 & 09 & 27.6 & 00:09 & 09 & 00 \\ \hline
23–51 & 35 & 31.68 & 19:16 & 21 & 14 \\ \hline Total/average & 514 & 38.11 & 255:258 & 421 & 93 \\ \hline \hline \end{tabular}  
* Gender for one patient is not given; T/FOM: tongue and floor of the mouth.  
\end{table} 
Table 4: Literature-review-based summary of 514 oral LEC. compared to oral LECs. Although we do not have data on special investigations that have been used, it is possible that an MRI, a CT-scan, or an ultrasound would refine the diagnosis of presumption. Ultrasound scanning is the first-line method of imaging choice, as the lesions are situated superficially. It will be useful to determine if there are any fistula connecting different organs, such as throat and ear. On the other hand, it is recommended to perform CT or MRI to determine the exact location of the cyst. The gold-standard treatment for both lesions is surgical excision. No recurrence is report in the literature for oral LECs [4,17]. The risk of recurrence of cervical LECs is 0-22% according to the studies [8,10,11,12].