Mucocele Research Articles

Bronchocele: Two Cases

A bronchocele (bronchial mucocele) results from the mucoid impaction and dilatation of the proximal bronchus caused by congenital bronchial atresia (CBA) or bronchial obstruction. Bronchocele must be considered in the differential diagnosis of radiologic pathologies. doi: http://dx.doi.org/10.4021/jmc1364w

Mucocele of the Appendix in Patients with Acute Appendicitis

DOI: 10.4328/JCAM.597 Received: 13.02.2011 Accepted: 18.02.2011 Printed: 01.01.2013 J Clin Anal Med 2013;4(1): 53-5 Corresponding Author: Ahmet Koyuncu, Kecioren Training and Research Hospital, Department of General Surgery, Kecioren, 06310, Ankara, Turkey. T.: +90 3123569000 F.: +90 3123569002 E-Mail: drahmet03@hotmail.com Ozet Appendiks mukoseli nadir karsilasilan bir durumdur. Genellikle asemptomatik seyreder ve radyolojik olarak genellikle batin sag alt kadranda kistik kitle olarak izlenir. Biz 77 yasinda appendiks mukoseli saptanan bir olguyu sunduk. Batin sag alt kadraninda izlenen kistik kitlelerde appendiks mukoseli klinik on tanilar arasinda mutlaka yer almalidir.

Analysis of follow-up outcomes of endoscopic modified Lothrop procedure

To sum up the follow-up outcomes of endoscopic modified Lothrop procedure (EMLP) and retrospectively analyze the indications, methods and prognostic factors of EMLP. The collected data of 73 cases who received EMLP with frontal sinus diseases were analyzed in this paper. The mean age was 45.6 (ranging from 14 to 72 years). There were 52 males and 21 females. Only patients with follow-up time greater or equal to 6 months were included. Paranasal sinus CT scan was adopted for all cases and MRI for tumor patients. All patients were followed under endoscope. There were 21 inverted papilloma in the frontal sinus, 16 chronic sinusitis with asthma, 12 frontal sinusitis, 9 chronic sinusitis with or without polyps, 7 osteoma of the frontal sinus, 4 frontal mucocele, 3 allergic fungal sinusitis and 1 congenital encephalocele. Sixty-one cases had prior surgical history (1.8 times on the average). Their mean follow-up was 25.0 months, (ranging from 6 to 122 months). At the end of follow-up, 44 cases (60.3%) had well opened frontal drainage pathway. Twenty-five (34.2%) was re-stenosed and 4 (5.5%) closed. Seven cases (9.6%) underwent revision surgeries. There were no surgical complications. EMLP is an effective and salvage procedure in dealing with tumor of frontal sinus and recurrent frontal sinusitis. Combined with medical treatment, EMLP will have a better results for chronic sinusitis with or without polyps and asthma. The degree of diseases, mucosal loss, anatomic variability and prior surgeries are important prognostic factors.

Clinical application of Draf IIb frontal sinusotomy and it's modified procedures

To summarize the follow-up outcomes of Draf IIb frontal sinusotomy and it's modified procedures, and to discuss the surgical indications and prognostic factors. Thirty-two patients treated between 2004 and 2010 were enrolled in this study. There were 15 patients for recurrent frontal inverted papilloma (IP), 6 for mucocele, 4 for recurrent frontal sinusitis, 3 for osteoma, 2 for meningoencephalocele with cerebrospinal fluid rhinorrhea, 1 for meningoencephalocele alone and 1 for acute frontal sinusitis. All patients underwent preoperative paranasal sinus computed tomography (CT) scans. Patients with tumor accepted magnetic resonance imaging (MRI). The patients with meningoencephalocele and cerebrospinal fluid rhinorrhea received magnetic resonance cisternography (MRC). The Draf IIb frontal sinusotomy and it's modified Draf IIb-1-3 procedures were applied endoscopically under general anesthesia mainly by high speed bur and power system. The postoperative CT scan was obtained as a base line for follow-up 1 week after the operation. Postoperative follow-up was performed under endoscope. Among 19 cases of Draf IIb, 12 were recurrent IP of frontal sinus, 4 were mucocele, 2 were recurrent frontal sinusitis and 1 were osteoma. Five cases received Draf IIb-1, 2 for each recurrent IP of frontal sinus and recurrent frontal sinusitis and 1 for osteoma. Six cases received Draf IIb-2, 3 for meningoencephalocele, 1 for each IP, acute frontal sinusitis and osteoma. Two cases received Draf IIb-3 were mucocele. The follow-up ranged from 8 to 73 months. Twenty-two cases of the frontal nepostium were widely opened, 7 were stenosis and 3 were closed. Revision surgery was seen in 2 cases with IP. All of them had no complications. The Draf IIb frontal sinusotomy and it's modified procedures are suitable for complex frontal sinus disease, which can be selected according to pathological and anatomical features, and have a good prospect for clinical application.

Isolated collagenoma mimicking mucocele on the lip

Isolated collagenoma mimicking mucocele on the lip

A Case of Petrous Apex Mucocele with Unilateral Ear Fullness Treated with Endoscopic Sphenoid Marsupialization

부비동 점액낭종(mucocele)은 점액 물질의 저류에 의해 생 기는 피막에 싸여 있는 병변으로 점액의 축적에 따라 팽창성 변화를 보인다. 이는 자발적으로 나타나는 원발성(primary) 과 수술이나 외상 등에 의하여 나타나는 이차성(secondary) 으로 나눌 수 있다. 부비동 점액낭종은 대부분 전두동과 사 골동에서 발생하는데 최근 영상 기술의 발전에 의해 접형동 점 액낭종의 발견율이 증가하고 있다. 접형동 점액낭종은 비특 이적 증상을 보이고 비내시경 검사상 발견이 어려우나 영상 검 사에서 발견할 경우 대부분 내시경 수술을 통해 합병증 없이 치료하고 증상을 호전시킬 수 있다. 저자들은 편측 이충만감을 주소로 타병원에서 시행한 영상 검 사상 접형동과 추체첨부의 점액낭종 소견을 보여 내원한 환자를 내시경하 조대술로 성공적으로 치료한 예를 보고하고자 한다. 증 례

Appendiceal mucocele mimicking right adnexal mass: a report of 25 cases

To explore the differential diagnosis and pertinent treatment of women with right lower quadrant abdominal mass. The clinical data of 25 women patients with appendiceal mucocele at our hospital from 2000 to June 2010 were recorded. And their clinical presentations, auxiliary examinations and treatment were analyzed retrospectively with the SPSS17.0 software. Among 1157 women undergoing appdicelectomy at our hospital, 25 (2.16%) had appendiceal mucocele. Their mean age was 58.2 years old. Their presenting symptoms and signs were non-specific. Ten cases (40%) were misdiagnosed as adnexal mass. The mass could be palpable by pelvic examination in 80% cases while 66.7% by abdominal examination. For preoperative auxiliary examination, the correct rate of ultrasonogram was 54.2% and CT 60%. The positive rate of carcinoembryonic antigen (CEA) was 57.1% while that of carbohydrate antigen 19 - 9 (CA199) 18.2%. Neither had statistical significance. There were three pathological entities: mucinous cystadenoma, malignant mucinous cystadenocarcinoma and simple retention mucoceles. Because of incidental discovery, the treatment remained variable. The approaches included appendectomy, cecectomy, right hemicolectomy and debulking according to the frozen pathological examination. As a rare condition, appendiceal mucocele is usually misdiagnosed as right adnexal lesion. Because of its anatomic position, it should be considered in the differential diagnosis of adnexal masses. Auxiliary examinations such as ultrasonogram, computed tomography and serum CEA may be helpful for its diagnosis. Its optimal management is achieved through an accurate preoperative identification and subsequently careful resection.

Apply mesh silica-drainage tube and mitomycin C synchronization during surgery to the effect of endoscopic frontal sinus surgery

Objective To investigate effect about application of mesh silica-drainage tube and mitomycin C (MMC) synchronization in endoscopic sinus surgery. Methods We selected 65 patients (116 sides)who have been operated on under nasal endoscopy in this study,included chronic frontal sinusitis,frontal mucocele,osteoma and inverted papilloma. 35 patients (64 sides) of the total was performed to apply mesh silica-drainage tube and MMC synchronization in endoscopic sinus surgery, which as MMC group;the other 30 patients (52 sides) who were not apply it as a control. What's more, all patients were followed 2 ～ 3 years after operation, and the postoperative efficacy and the incidence of complication in the two groups were compared. Results The total effective rate in MMC group(97.4%) was higher.than that of the control group(72.9%) (P<0.01). In MMC group, nasal adhesion after endoscopic sinus surgery was 1 case, and the incidence of complication was 1.6% ;but in control group, nasal adhesion was 7 cases,the ostium of frontal sinus atresia 1 case, the nasofrontal duct stenosis 2 cases, recurrence of the polyps or tumors 2 cases, so the incidence of complication was 23.1% The incidence of complication rate in MMC group was lower than that of the control group (P<0.01)Conclusion To apply mesh silica-drainage tube and mitomycin C synchronization in endoscopic sinus surgery can improve clinical effects of operation method, and postoperative complications are obviously decreased. So this method is convenient, safe and effective. Key words: Endoscopy surgery; Mitomycin C; Nasal sinuse

Idiopathic Maxillary Sinus Mucocele

Mucocele of the maxillary sinus is a relatively rare location among all the paranasal sinus mucoceles. Maxillary sinus mucoceles usually grow gradually and can erode surrounding structures, which result in associated symptoms. The most common presenting symptoms include dull maxillary facial pain, swelling of the cheek, and nasal obstruction. It is rare to cause orbital and ocular involvement. Here we present a case of a 72-year-old man who sustained swelling around the right cheek and lower eyelid region associated with epiphora and blepharoptosis. Computed tomographic scan of the paranasal sinus revealed a large maxillary mucocele with bony erosion and compression of the right globe. The symptoms of cheek swelling and blepharoptosis resolved immediately after endoscopic marsupialization was performed. The case report demonstrates that maxillary sinus mucoceles may invade the orbit secretly and should be considered in the differential diagnosis in patients presented with eye problems. Early diagnosis and timely surgical intervention are important to reduce inevitable complications.

전두사골동 점액낭종과 분리된 안와내의 점액낭종

전두사골동 점액낭종과 분리된 안와내의 점액낭종

Late Presentation of a Mucocele of the Frontal Sinus: 50 Years Postinjury

malignancies: An 18-year single institution experience. Laryngoscope 112:1964, 2002 31. Kim BS, Vongtama R, Juillard G: Sinonasal undifferentiated carcinoma: Case series and literature review. Am J Otolaryngol 25:162, 2004 32. Kramer D, Durham JS, Sheehan F, et al: Sinonasal undifferentiated carcinoma: Case series and systematic review of the literature. J Otolaryngol 33:32, 2004 33. Resto VA, Deschler DG: Sinonasal malignancies. Otolaryngol Clin N Am 37:473, 2004 34. Pino RV, Montero GC, Marcos GM, et al: Sino-nasal undifferentiated carcinoma. Report of 1 case and literature review. An Otorrinolaringol Ibero Am 31:325, 2004 35. Enepekides DJ: Sinonasal undifferentiated carcinoma: An update. Curr Opin Otolaryngol Head Neck Surg 13:222, 2005 36. Dulguerov P, Allal AS: Nasal and paranasal sinus carcinoma: How can we continue to make progress? Curr Opin Otolaryngol Head Neck Surg 14:67, 2006 37. Donald PJ: Sinonasal undifferentiated carcinoma with intracranial extension. Skull Base 16:67, 2006 38. Stewart FM, Lazarus HM, Levine PA, et al: High-dose chemotherapy and autologous marrow transplantation for esthesioneuroblastoma and sinonasal undifferentiated carcinoma. Am J Clin Oncol 12:217, 1989 39. Greger V, Schirmacher P, Bohl J, et al: Possible involvement of the retinoblastoma gene in undifferentiated sinonasal carcinoma. Cancer 66:1954, 1990 4 0 . Rosenthal G, Gomori JM, Tobias S, et al: Unusual cases involving the CNS and nasal sinuses. J Clin Oncol 21:3875, 2003 41. Rosenthal DI, Barker JL, El-Naggar AK, et al: Sinonasal malignancies with neuroendocrine differentiation. Patterns of failure according to histologic phenotype. Cancer 101:2567, 2004 42. Kouri M, Kankaanranta L, Seppala T, et al: Undifferentiated sinonasal carcinoma may respond to single-fraction boron neutron capture therapy. Radiother Oncol 72:83, 2004 43. Mendenhall WM, Mendenhall CM, Riggs CE, et al: Sinonasal undifferentiated carcinoma. Am J Clin Oncol 29:27, 2006 44. Cohen ZR, Marmor E, Fuller GN, et al: Misdiagnosis of olfactory neuroblastoma. Neurosurg Focus 12:1, 2002 45. Greene FL, Page DL, Fleming ID, et al: Nasal cavity and paranasal sinuses, in AJCC Cancer Staging Manual (ed 6). New York, Springer-Verlag, 2002, pp 59-67 46. Hyams VJ, Batsakis JG, Michaels L, et al: Tumors of the upper respiratory tract and ear, in Atlas of Tumor Pathology. 2nd series, Fascile 25. Washington, DC, Armed Forces Institute of Pathology, 1988, p 248 47. Kadish S, Goodman M, Wang CC: Olfactory neuroblastoma. A clinical analysis of 17 cases. Cancer 37:1571, 1976 48. Rischin D, Porceddu S, Franzar LP, et al: Promising results with chemoradiation in patients with sinonasal undifferentiated carcinoma. Head Neck 28:435, 2004 49. Norleza AN, Gendeh BS: Challenges in the treatment of sinonasal undifferentiated carcinoma: A ray of hope. Med J Malaysia 60:281, 2005 5 0 . Ghosh S, Weiss M, Streeter O, et al: Drop metastasis from sinonasal undifferentiated carcinoma. Clinical implications. Spine 26: 1486, 2001

Evaluation of mucocele of the appendix:high frequency ultrasonic wave

Objective To investigate the high frequency ultrasonic wave features of mucocele of the appendix,and to improve the diagnostic ability of the disease. Methods All 7 patients with mucocele of the appendix were confirmed by pathology and surgery. High frequency ultrasonic wave findings were analyzed retrospectively. Resuits The high frequency wltrasonic wave demonstrated a mass of low attenuation in the right lower quadrant in all 7 cases. The masses were either spherical( n = 2) or elongated ( n = 5) in shape. Two masses had mural calcification,and 4 had mural enhancement after contrast enhancement. The mueocele inside full liquid was a homogeneous cystic mass in 3 cases,cystic mass with internal septations in 1 case,and cystic mass with peripheral solid tissue in 1 case.Conclusion The high frequency ultrasonic wave scan is a useful method in differential diagnosis mucocele of the appendix. Key words: Appendix; Mucocele; Ultrasonography, Doppler, color

Mucinous cystadenoma of the appendix associated with muscular and neuromatous hyperplasia: report of a case.

Mucinous cystadenoma of the appendix is a type of appendiceal mucocele and a rather rare condition usually found incidentally in the course of other abdominal surgery. A previous evaluation of 73 appendiceal mucoceles showed that this disease was often associated with adenocarcinoma and other epithelial atypia. This observation suggested that patients with mucinous cystadenoma of the appendix also have some underlying disorders. However, non-epithelial changes associated with appendiceal mucocele have not been reported so far. In this study, we presented for the first time a mucinous cystadenoma of the appendix associated with muscular and neuromatous hyperplasia.

術前に虫垂粘液嚢腫と診断し，腹腔鏡下虫垂切除術を施行した虫垂仮性憩室の１例

症例は56歳, 男性. 便柱狭小化, 右下腹部違和感を主訴に前医を受診し, 虫垂腫瘍と診断され, 精査加療目的に当院へ紹介された. 画像検査で虫垂粘液嚢腫を疑い, 腫瘤径が約2cmと小さいため腹腔鏡下虫垂切除を施行した. 切除標本上, 虫垂間膜側に1.8cmの虫垂憩室を認め, 病理組織学的に虫垂仮性憩室と診断した. 虫垂憩室は穿孔の可能性が高く, 治療の対象となり得るが, 本症例のように虫垂粘液嚢腫と類似した画像所見を呈する場合がまれにあり, 注意を要する. 一方, 虫垂粘液嚢腫は腹膜偽粘液腫を来す恐れがあり, 従来, 開腹下の虫垂切除術や回盲部切除術, 結腸右半切除術が行われてきたが, 過形成や粘液嚢胞腺腫では治療として虫垂切除術で十分である. 虫垂粘液嚢腫や虫垂憩室を含む小さい虫垂嚢胞性疾患全般の治療法として, まず腹腔鏡下虫垂切除術を考慮し, 必要に応じて追加腸切除を考慮すべきである.

Mucocele of the Neck

Mucocele of the Neck

Oral Neurilemmomas-A Clinicopathological Study of 21 Cases

Oral neurilemmomas (ON) are rare oral lesions. Twenty-one cases of ONs diagnosed and treated in our institute during the period from January 1991 to June 2004 were analyzed in this study. There were 14 male and 7 female patients. The mean age of the 21 patients at the time of diagnosis was 30 (range, 14-67) years with a peak incidence of tumor occurrence in the third decade. The more-common sites for an ON were the tongue (8 cases) and buccal mucosa (5 cases). The clinical appearance of ONs was frequently a pink, movable mass. In only 1 case was palpation tenderness noted. The greatest dimension of the lesion was 2 cm with a mean of 1.0±0.5 cm. The duration of the lesion ranged from 10 days to 10 years with a median of 6 months. Of the 21 cases, the clinical diagnosis was a fibroma in 6, a mucocele in 4, a tongue or buccal tumor in 5, and others in 6. Surgical excision was the treatment of choice for all 21 lesions. None of the lesions showed recurrence after surgical excision. On the average, our 21 ONs contained 77%±16% Antoni A tissue and 23%±16% Antoni B tissue. We conclude that ONs occur most often in the third decade. The more-commonly affected sites are the tongue and buccal mucosa. ONs often present as a painless and movable mass which is very difficult to diagnose just based on their clinical features. Our ONs were mostly composed of Antoni A tissue, with much-smaller content of Antoni B tissue.

Mucous extravasation phenomena in babies

Mucous extravasation phenomena are rare in children in the first year of age. The authors report a case of a mucocele in the lower lip of an 8-month-old child and a case of congenital ranula. The patients didn’t receive any treatment for the lesions and are under clinical follow-up for 14 months with signs of spontaneous remission of both lesions. Treatment indications and difficulties in the management of patients in this age group are discussed.

虫垂粘液嚢腫に対し腹腔鏡下切除を施行した血液透析患者の１例

虫垂粘液嚢腫は比較的稀な疾患である.われわれは血液透析患者に合併した虫垂粘液嚢腫に対し,腹腔鏡にて最終診断し切除し得たので報告する.症例は83歳,女性で,右下腹部痛にて当院に入院した.腹部単純写真,断層写真,注腸にて虫垂粘液嚢腫,卵巣嚢腫が疑われたが最終診断には至らなかった.患者が高齢かつ血液透析中である事より,確定診断を得るとともに,低侵襲な手術を目的として鏡視下手術を施行した.腹腔鏡観察にて虫垂粘液嚢腫の確定診断を得,かつ鏡視下にて切除も可能であった.虫垂粘液嚢腫のhigh risk症例に対して,鏡視下手術は非常に有用な手段と考えられた.

Postsurgical mucocele

Postsurgical mucocele

嚢胞内ＣＥＡ値が高値を呈した虫垂粘液嚢胞の１例

症例:72歳,男性.主訴は便秘.注腸X線検査では,虫垂が造影されず,盲腸底部に径約2cm大の隆起があり,その中央に小隆起を認めた.大腸内視鏡検査では,虫垂開口部が腫大し,その中心に小隆起を認めた.同部からの生検ではリンパ濾胞過形成がみられた.腹部US,腹部CT検査では回盲部に径約1.5～2.0cm,長さ約5cm大,嚢状に腫大した虫垂を認めた.虫垂嚢胞と診断したが,悪性病変の合併を否定し得ず,回盲部切除を施行.肉眼的には棍棒状に腫大し,波動感を伴う虫垂であり割面では虫垂開口部はリンパ濾胞過形成や炎症性変化で閉塞されていた.組織学的には腫瘍細胞はみられず,retention cystと診断された.嚢胞内容液CEA値は2000ng/ml以上(血中CEA値1.3ng/ml)と高値を呈していた,この様な症例の報告は見当らず,若干の文献的考察を加えた,