Retention Cysts Research Articles

Homoeopathic intervention in classic case of oral mucocele: A case report

Oral mucocele is a common reactive lesion of the oral mucous that result from an alteration or obstruction of minor salivary glands due to a mucous accumulation causing swelling and inflammation of the localized area. Two common conditions are:1.Extravasation (common site-lower lip)2.Retention (common site-others)The ‘retention cysts’ (commonly termed as ranula) are the cystic degeneration /blockage of the ‘sublingual salivary glands or glands of ‘blandin and nuhm’ that are situated in the floor of mouth or under surface of tongue. It is also known as mucous cyst of oral mucosa.Whereas on the other hand, ‘extravasation cysts’ are the result of traumatic injury of salivary gland duct is mostly common in children and young adults with peak in 2nd decade of their life.This ‘Benign Lesion’ affects the younger generation the most, in which homoeopathic approach aids the most in its proper treatment. The paradigm of clinical presentation along with history of evolution of lesion paves the direction of appropriate diagnosis. Although it is always wise to subject it to histopathological confirmation owing to its close resemblance to neoplastic condition. This article in particular deals and explains, ‘A Case Of Extrvastion Of Mucocele On Lower LIP’ in a 27-year-old young man.

Unexpected additional pathologies at the surgical margins of oral squamous cell carcinoma.

There is a scarcity of literature on the presence of additional unexpected pathologies at the surgical margins of oral squamous cell carcinoma (OSCC). It is quite possible that such pathologies might get overlooked because of primary focus on the malignancy at the surgical margins. With this view in mind, a retrospective observational study has been designed to re-visit the surgical margins of OSCC for the possible presence of unexpected pathologies. Haematoxylin and eosin-stained sections of 96 cases (four surgical margins in each case) of OSCC were carefully examined under a compound microscope by two oral pathologists for the presence of any additional pathology. Out of 96 specimens of OSCC, 76 (79.2%) cases showed the presence of accidental pathologies. The surgical margins of 20 (20.8%) cases showed no evidence of any pathology, whereas the margins of 23 (23.95%) cases were associated with more than one pathology. The most commonly observed accidental pathology was oral submucous fibrosis (40.625%), followed by leukoedema (16.675%), retention cysts (10.42%), and calcifications (7.3%). The mucous extravasation phenomenon (6.25%), minor salivary gland (MSG) inflammation (6.25%), and lichen planus (5.21%) were also observed in the surgical margins of OSCC. A significant number of accidental pathologies exist at the surgical margins of OSCC. This effect could be because of over-emphasis on the tumour status at the surgical margins, which leads to over-looking of minor pathologies.

Ranula as an early symptom of Sjögren’s syndrome

Introduction and purpose: 
 Sjögren's syndrome is an autoimmune disease affecting exocrine glands, mainly salivary glands. A ranula is a type of retention cyst associated with salivary extravasation that develops within the large salivary glands. The most common reason of developing ranula is trauma of bottom of the oral cavity. Damaging the sublingual gland, due to changes in Sjögren’s syndrome, may lead to the development of ranula. The aim of this review is to analyze the possible impact of ranulas on early diagnosis of Sjögren's syndrome.
 Material and method:
 This review was based on articles collected in PubMed and published in the years 2003-2021 and books from 2009 and 2018. Articles were chosen using keywords such as "Sjögren's syndrome", "ranula", “mucocele” and "early diagnosis".
 Results:
 Ranulas are considered to be early clinical signs of Sjögren's syndrome. Undergoing diagnostic imaging in patients with ranulas allows to diagnose Sjögren's syndrome in early stage and implement appropriate therapy.
 Conclusion:
 Identification of ranula should suggest implementation of diagnostics of Sjögren's syndrome using imaging methods such as magnetic resonance imaging or ultrasonography. Early diagnosis of Sjögren's syndrome is crucial to start the adequate treatment and get better results. It is recommended to include imaging tests in the diagnostic criteria of adolescent and adult SS in order to facilitate the diagnosis at an earlier stage of the disease.

What could this dark lesion on a woman’s eyelid be?

What could this dark lesion on a woman’s eyelid be?

Bilateral Mucous Retention Cyst of the Submandibular Salivary Gland: A Rare Unusual Presentation and Review of the Literature.

Background: Mucous Retention Cyst (MRC) are non-neoplastic, developmental salivary gland lesion. Although more common in the minor salivary gland, few cases have been reported in the major salivary gland.
 Objective: To draw the attention of clinicians to a rare occurrence of MRC in the submandibular gland bilaterally.
 
 Case Report: The index case presents as a slowly progressive painless lesion of 10 years duration associated with aesthetics concerns. The lesion appeared as a double jaw with extension into the neck. Though lobulated and fluctuant, aspirate yielded yellow coloured, non-viscous and non-foul smelling fluid. Ultrasonography revealed a multilobulated mass with mobile heterogeneous fluid-like content in the submental and submandibular regions bilaterally. The massive size of the lesion limited the ultrasonic visualization of the submandibular salivary glands. The patient could not afford advanced imaging. During surgery, the lesion had involved the submandibular gland bilaterally with attachment to the hyoid bone and in close relation to the recurrent laryngeal nerve. Although the nerve was preserved, the patient experienced temporary hoarseness, which resolved with medication. Histopathologic examination of the excised lesion revealed the lesion as Mucous Retention Cyst.
 Conclusion: The massive size of the lesion, delayed presentation and financial constraints in obtaining advanced imaging could have contributed to the diagnostic dilemma. This rare case will help the clinicians include MRC as a differential diagnosis of lesions involving submandibular salivary gland bilaterally. It also draws the attention of the maxillofacial surgeons to the unexpected injury to the recurrent laryngeal nerve and its management in a low-income setting environment.
 

Evaluation of Mucous Retention Cyst Prevalence on Digital Panoramic Radiographs in the Local Population of Iran.

Introduction Inflammatory diseases and cysts such as mucous retention cysts (MRCs) and benign tumors include a large proportion of lesions of the mouth, teeth, and jaw. The most common complication of this lesion is sinusitis. Due to the high frequency of these cysts in panoramic radiography of patients referred to dentistry, this study aimed to evaluate the frequency of mucous retention cysts in the maxillary sinus on panoramic images of the local population in Birjand in the year 2020. Methods In this descriptive research design study, 1624 digital panoramic radiographs of patients referred to the oral and maxillofacial radiology department of Birjand Dental School were selected randomly. Cases were evaluated in terms of MRC appearance by two oral and maxillofacial radiology specialists. Then, based on sex, location, and size of the cysts, the images were assessed. In the predesigned checklists, data were recorded. The MRC diagnosis was confirmed by observation of a dome-shaped radiopaque view on the floor or sinus walls with a smooth surface with no cortical margin. MRCs were categorized into one of three groups by size: 1- less than 10 mm, 2- between 10 and 20 mm, and 3- more than 20 mm. Bilateral or unilateral involvement of lesions was noted. Seasons of the year (P < 0.05). There was no significant relationship between the month of the year and the prevalence of cysts (P > 0.05). Results MRCs were detected in 80 panoramic images of 1624 (9/4), of which 54 patients (67.5%) were male and 26 patients (32.5%) were female. Of those 34 (42.5%), the total cases were between 30 and 40 years old. Most cysts (58.8%) were in the right sinus, and their size was 10–20 mm mainly (43.4%). Based on the results, there was a significant relationship between the prevalence of MRCs with age and sex. Conclusions Panoramic images are so helpful in MRC detection. In this study, the frequency of MRCs is the highest in males between 30 and 40 years old. These lesions are reported mainly as unilateral and solitary in spring.

Molecular assessment of endoscopically collected pancreatic juice and duodenal fluid from patients with pancreatic diseases.

One concern associated with pancreatic diseases is the poor prognosis of pancreatic cancer. Even with advances in diagnostic modalities, risk stratification of premalignant lesions and differentiation of pancreatic cysts are challenging. Pancreatic lesions of concern include intraductal papillary mucinous neoplasms, mucinous cystic neoplasms, serous cystadenomas, pseudocysts, and retention cysts, as well as cystic degeneration of solid tumors such as solid pseudopapillary neoplasms and pancreatic neuroendocrine neoplasms. Pancreatic juice obtained during endoscopic retrograde cholangiopancreatography has previously been used for the detection of KRAS mutation. Recently, duodenal fluid, which can be obtained during the relatively minimally invasive procedures of endoscopic ultrasound (EUS) and esophagogastroduodenoscopy, and cyst fluid collected by EUS-guided fine-needle aspiration (FNA) were used for molecular biological analysis. Furthermore, advanced analytic methods with high sensitivity were used for the detection of single and multiple markers. Early detection of malignant pancreatic tumors and risk stratification of premalignant tumors can be performed using duodenal fluid samples with a single marker with high sensitivity. Technological advances in simultaneous detection of multiple markers allow for the differentiation of cystic pancreatic tumors. One thing to note is that the clinical guidelines do not recommend pancreatic cyst fluid and pancreatic juice (PJ) sampling by EUS-FNA and endoscopic retrograde cholangiopancreatography, respectively, in actual clinical practice, but state that they be performed at experienced facilities, and duodenal fluid sampling is not mentioned in the guidelines. With improved specimen handling and the combination of markers, molecular markers in PJ samples may be used in clinical practice in the near future.

Optimal timing of endoscopic sinus surgery for the retention cyst of maxillary sinus.

The optimal timing of functional endoscopic sinus surgery for odontogenic infections precipitated by retention cysts of the maxillary sinus was investigated. Five adults who underwent functional endoscopic sinus surgery were examined. The root apexes of all teeth that had odontogenic infection protruded into the maxillary sinus. All teeth with odontogenic infections precipitated by the retention cysts had percussion pain, indicating they had periodontitis and pulpitis around the root apex. They were vital teeth, indicating they did not have pulp necrosis. The small area of cyst wall attached to the floor of the maxillary sinus and root apex were left intact. The teeth that had odontogenic infections precipitated by retention cysts continued to be vital with no symptoms. Functional endoscopic sinus surgery should be performed before periodontitis and pulpitis of the root apex progress to ascending pulpitis and pulp necrosis. In other words, functional endoscopic sinus surgery should be performed while the affected tooth is still vital.

A case of sublingual ranula that successfully responded to micro-marsupialisation under COVID-19 infection: A case report

Ranula is a mucous retention cyst caused by the extravasation of mucus from the sublingual gland. We present a case of sublingual ranula that was successfully treated with micro-marsupialisation under COVID-19 infection. The patient was a 17-year-old Japanese male suffering from a sublingual ranula that did not improve after several rounds of puncture-aspiration therapy. The patient underwent OK-432 injection therapy under hospitalisation. However, the swelling worsened. Thus, micro-marsupialisation was subsequently performed. After micro-marsupialisation, the lesions flattened out, but 14 days after treatment, the patient was found to have asymptomatic COVID-19 infection when he underwent polymerase chain reaction testing as a close contact person. Simultaneously, the lesion re-swelled and became painful, so non-steroidal anti-inflammatory drugs were prescribed. The next day, the sutures spontaneously detached, viscous saliva and blood overflowed, and the ranula disappeared. Micro-marsupialisation is effective and useful even if the patient has a COVID-19 infection.

A NOTEWORTHY PRESENTATION OF HYDATID CYST - CASE REPORT

In general Swelling over sublingual regions will be provisionally diagnosed as Dermoid cyst / Ranula / Mucous retention cyst / Salivary gland tumours. But in rarest of rare cases, there may be chances of a Hydatid cyst. Hydatid disease or Echinococcosis is a zoonotic disease caused by Echinococcus granulosus as seen in this 29years old female with swelling over the sublingual region extending into the neck. Clinically appeared as dermoid cyst and radiological investigations suggestive of the possibility of ranula, so planned for surgery but surprisingly on table after opening the swelling there was a tough brous layer with underneath thick whitish lamellated membrane, anticipated as hydatid cyst which was also conrmed by the histopathological report.

Surgical outcomes between two endoscopic approaches for maxillary cysts

ObjectiveTo compare recurrence rates and symptomatic relief in symptomatic maxillary sinus Retention Cysts (RCs) between Middle Meatus Antrostomy (MMA) alone and Inferior Meatus Antrostomy (IMA) with basal mucosa electrocoagulation. MethodsPatients with symptomatic unilateral maxillary RCs were randomly allocated to MMA (n=54) and IMA combined with mucosa electrocoagulation (n=53) groups. Symptomatic relief, cyst recurrence, and closure of the antrostomy opening were compared at 12-months postoperatively. ResultsSymptomatic failure occurred in 13 (12.1%) patients, including 9 (16.7%) MMA and 4 (7.5%) IMA patients; this difference was not statistically significant (p=0.251). Postoperative cyst recurrence occurred in 16 (29.7%) and 1 (1.9%) patient in the MMA and IMA groups, respectively (p<0.0001). Closure of the opening occurred in 7 (13.0%) and 17 (32.1%) patients in the MMA and IMA groups, respectively (p=0.032). However, there were no significant pairwise correlations between closure of the opening and symptomatic failure or cyst recurrence. ConclusionIMA combined with basal mucosa electrocoagulation and MMA alone provided similar symptomatic relief for symptomatic maxillary RCs, but IMA had shorter operation times and lower postoperative recurrence rates of RCs. Level of evidenceLevel 1b.

PENILE NEUROFIBROMA IN A 10-YEAR - OLD CHILD: A RARE CASE STUDY

Neurofibromas of the penis occur uncommonly and their solitary occurrence is even rarer. We report a case of a ten year old child presenting with a solitary neurofibroma located on penis. Aprovisional clinical diagnosis of penile retention cyst was made and histopathological examination releaved a benign spindle cell lesion and few close differential diagnosis were made, which on application of immunohistochemistry was diagnosed as neurofibroma of penis. Surgical excision of the lesion was done and there was no recurrence after a year of follow up.

A huge high rising cervico-facial lymphangioma in an adolescent male: from pterygoid to hyoid

&lt;p class="abstract"&gt;Cervicofacial lymphangioma is a benign swelling of the neck and is commonly seen in paediatric population. Common sites of involvement are the submandibular space and the posterior triangle and rarely involves the face. We present a rare case of a huge cervico-facial lymphangioma in a 14 year old male where the swelling presented one year back and had progressively increased in size extending from the medial pterygoids and pterygomandibular space above to myelohyoid muscle below. Intraoperatively, it was closely abutting the submandibular gland mimicking salivary gland retention cyst and the facial artery was traversing through the mass. Complete surgical excision of the mass was performed along with removal of the ipsilateral submandibular gland. Salivary gland mucocele and cervicofacial lymphangioma were the two main differential diagnosis in our case. Intraoperative findings of macrocystic spaces with septations pointed towards a lymphangioma. Post operative histopathology confirmed it to be lymphangioma lined with endothelial cells. We concluded from this case that cervicofacial swellings in higher age groups should have lymphangiomas as differential diagnosis. As the swelling ascended up to the skull base, careful radiological assessment, meticulous surgical plan and cranio-caudal exposure from the zygomatic arch above to the hyoid below helped in complete surgical excision of the mass. &lt;/p&gt;

Esophageal retention cyst: Esophagogastric junction outflow obstruction (EGJOO) as a potential etiology and management with endoscopic mucosal resection (EMR).

Introduction and importanceEsophageal retention cysts are acquired cysts with no known etiology. They are characterized by dilation of the submucosal glands. Symptomatic cysts are traditionally managed by surgical resection.Case presentationWe present a case of progressive dysphagia and chest pain secondary to esophageal retention cysts in the mid and distal esophagus with associated esophagogastric junction outflow obstruction (EGJOO) and jackhammer esophagus on high resolution manometry (HRM). The patient underwent staged endoscopic mucosal resection (EMR) with subsequent improvement in her symptoms. However, EGJOO persisted after resection, suggesting it was the primary pathology and not a consequence of the obstruction from the cysts.Clinical discussionEsophageal retention cysts are rarely reported in the literature with most descriptions coming from incidental post-mortems. The presented case suggests EGJOO as a potential etiology of retention cysts. The proposed mechanism is that a significant rise in esophageal intraluminal pressure creates a state of stasis in the esophagus, ideal for the development of these cysts. Symptomatic or malignant retention cysts should be resected. We demonstrate the feasibility of EMR as an alternative to surgical resection.ConclusionEsophageal retention cyst is a rare entity, which may arise as a result of EGJOO. The natural history and malignant potential of these cysts are unknown, and no formal guidelines have been established for follow-up for patients with asymptomatic retention cysts. Endoscopic mucosal resection can be used to successfully manage these cysts.

Sinus floor augmentation and implant placement on maxillary sinus with mucous retention cyst: case report

Sinus floor augmentation and implant placement on maxillary sinus with mucous retention cyst: case report

Congenital epidermoid cyst associated with mucus retention cyst in Wharton's duct of a newborn. Report of an unusual case

<h3>Objectives</h3> The differential diagnosis of cystic swellings involving the floor of the mouth includes various lesions, such as dermoid, epidermoid or lymphoepithelial cysts and ranulas. However, coexistence of such conditions, pos- sibly with a cause-and-effect relationship, is rare. Herein, we present a case of congenital epidermoid cyst in asso- ciation with mucus retention cyst in the floor of mouth of a newborn. <h3>Findings</h3> A 6 months old female infant was referred for evaluation of a "pearly" yellowish swelling in the floor of mouth, first noticed by her pediatrician just after birth. Slow enlargement of the lesion was reported. Clini- cal examination revealed a yellowish nodule with overlying prominent vasculature in close association with the orifice of the left submandibular duct, posteriorly transitioning to a diffuse bluish cystic swelling of the left floor of mouth. With a provisional diagnosis of a developmental cyst and/or ranula, a surgical excision was performed under general anesthesia. Intraoperatively, an anterior round lesion was identified, extending posteriorly towards the submandibular gland as an elongated cylindrical cystic dilatation. Histopathologic examination revealed a well- defined cystic cavity in the anterior aspect lined by keratinized stratified squamous epithelium with compact keratin deposition inside the lumen. The cystic lesion showed continuity with a dilated salivary duct aligned by cylindrical, cuboidal or pseudostratified epithelium. A final diagnosis of epidermoid cyst intimately associated with a mucus retention cyst (ranula) of the submandibular duct was rendered. <h3>Conclusions</h3> The coexistence of two cystic lesions in the floor of the mouth with features of epidermoid and mucus retention cyst, respectively, is rare and its pathogenesis intriguing, especially in a newborn. Theoretically, the two lesions may be coincidental, although a more reasonable explanation is that a congenital epidermoid cyst, inciden- tally developing adjacent to the submandibular duct orifice, caused obstruction and secondary mucus retention phenomenon.

Papillary synovial metaplasia-like change in oral mucoceles: A retrospective institutional study of 105 cases.

Background:Mucoceles are mucus-filled cavities and are broadly of two types: mucus retention cysts and mucus extravasation phenomenon. A wide variety of histological features have been documented in the literature. The present study was an attempt to study these histological features: papillary synovial metaplasia-like changes (PSM-like changes) in particular.Materials and Methods:One hundred and five tissue samples of mucoceles were retrieved and evaluated for age, gender, type, site, color, etiology, symptoms, dimension of the lesion and presence or absence of PSM-like changes. The results were documented on Microsoft Excel spreadsheet and analyzed by using SPSS.Results:All 105 cases were of mucus extravasation phenomenon with a definitive male preponderance. The mean age of occurrence was 25.82 ± 11.65 years and a predilection for the lower lip. PSM-like changes were seen in 31 cases (Group II), and the remaining 74 cases did not show a definite presence of these features (Group I). The cases in Group II were statistically larger in dimension than Group I cases. No difference was noted in age, gender and laterality.Conclusion:PSM-like changes appear to be an underrecognized histological alteration seen in oral mucoceles and must be recognized to differentiate from other salivary gland entities showing papillary architecture.

Mucinous lesions of the appendix: a histopathological study

Background: Mucinous lesions of the appendix are frequently misinterpreted in histopathological examination due to their relative rarity. Our study focuses on interpreting the histopathological spectrum of such lesions and understanding the disease burden of appendiceal mucinous lesions in a tertiary centre. Materials and Methods: This was a retrospective cross-sectional study conducted in the Department of Pathology. Gross and microscopic findings of appendicectomy specimens with mucinous lesions were analysed and classified according to the latest WHO 2019 recommendation. Results: Seven hundred and forty appendicectomy specimens were received during the study period out of which nine appendix (1.2%) had mucinous lesions. Five (55.6%) of these lesions had a mucinous neoplasm while four of them (44.4%) were non-neoplastic. The most common lesion was low-grade appendiceal mucinous neoplasm (n=4; 44.4%). Two cases (22.2%) were retention cysts and there was one case each of mucinous adenocarcinoma, appendiceal diverticulosis, and endometriosis-associated mucinous metaplasia of the appendix. The mucinous neoplasms were significantly more common in females (80%). High-grade appendiceal mucinous neoplasms and serrated lesions or polyps weren’t seen in our study. Conclusions: Mucinous lesions of the appendix are often incidental findings in patients operated for symptoms of acute appendicitis. Low-grade appendiceal mucinous neoplasms are the most common among them. Thorough knowledge of the neoplastic mimics and careful gross, as well as microscopic examination, is a must for proper diagnosis and staging since it has a significant impact on further patient management and prognostication.

Sonoelastography evaluation in the diagnosis of endometrial pathology combined with chronic endometritis in infertile women.

Endometrial pathology, including hyperplastic processes in the structure of reproductive disorders, occupies one of the leading places along with inflammatory diseases of the pelvic organs, contributing to infertility in 80% of cases and irregular menstrual cycle in 40–43%. This study aims to optimize the diagnostic algorithm in patients with endometrial hyperplasia combined with chronic endometritis and determine qualitative indicators of compression sonoelastography in patients with endometrial pathology and infertility. A comprehensive clinical and laboratory examination of 90 infertile patients aged 25 to 45 years with endometrial hyperplasia combined with chronic inflammation, retention cysts, and benign ovarian tumors was carried out. The results of clinical-laboratory and complex ultrasound examination with compression sonoelastography were compared with the data of pathomorphological and immunohistochemical studies. A high percentage of pelvic inflammatory disease (55.0%), benign lesions of the cervix (67.5%), hyperplastic processes of the myometrium (37.5%), an increasing number of polyps by 2.9 times, leiomyomas and adenomyosis – by 2.3 times (p<0.05) was established. In the case of a combination of endometrial hyperplasia and ovarian cysts, a high percentage of comorbidity of gynecological pathology is verified (37.8%), and the use of compression sonoelastography allows to establish class II and class III elastograms in 91.1% of cases which characterize benign endometrial lesions, reduce the number of false-positive results in 95.6% of cases, correctly interpret the nature of pathological changes and increase the sensitivity of ultrasound techniques.

The Relationship between an Accessory Maxillary Ostium and Variations in Structures Adjacent to the Maxillary Sinus without Polyps.

Introduction The maxillary sinus and its variations are very important to dentistry and rhinology. Objective To investigate the effect of the accessory maxillary ostium (AMO) on the variations of adjacent structures of the maxillary sinus. Methods The computed tomography (CT) images of 400 patients were retrospectively evaluated. The prevalence of AMO was calculated. The relationship between morphological variations of adjacent structures of maxillary sinus such as agger nasi cell (ANC), Haller cell (HC), nasal septum deviation (NSD), hypertrophy of inferior concha (HIC), pneumatization of middle concha (PMC), mucus retention cyst (MRC), mucosal thickening (MT), and maxillary sinusitis (MS), as well as the presence of AMO, were investigated. Results Presence of AMO was diagnosed in 42 patients (10.5%), having been found in 4.5% of the patients only on the right side, in 1.25% of the patients only on the left side, and in 4.75% of the patients on both sides. There is an increasing incidence of ANC, HC, NSD, HIC, and PMC in the presence of AMO and MS. There is a decreasing incidence of MRC in the presence of AMO. Furthermore, AMO does not affect the incidence of MT. Conclusion This study showed that most parameters, except for MRC and MT, had increasing incidence in the presence of AMO. It is important for radiologists and rhinologists to have knowledge about the location of AMO and the presence of variations of MS adjacent structures to avoid surgical complications.