Superficial Mucocele Research Articles

Conventional Surgical Excision of Lower Lip Mucocele in Children

Introduction: Mucoceles, as a mucus escape reaction or mucus extravasation phenomenon, are prevalent benign abnormality affecting the salivary glands. Most commonly occur in the lower lip in children and young adults. It emerges in response to trauma and obstruction of salivary gland ducts. Mucoceles are typically painless but can be troublesome for individuals while eating and speaking. Case report: An 8-year-old boy reported a lower lip mucocele due to their habit of lip biting. The lesion has been treated with a conventional surgical excision under local anesthesia and followed up after one week. The results showed that the mucocele lesion healed, no remnant was seen, and there was no complaint from the patient. Discussion: Oral mucoceles in the lower lip occur in children due to mucosa trauma or lip biting. For the patient reported here, conventional surgical excision using a scalpel was the treatment option due to the small size and superficial form of the lesion, so excisions can be done more easily with minimal postoperative wounds. Conclusion: Conventional surgical excision guarantees the removal of a whole small superficial mucocele lesion. Moreover, identifying the underlying cause of oral mucocele is crucial for patient education, enabling them to comprehend their condition and take measures to prevent its recurrence.

Tongue Mucoceles: a retrospective clinic-pathological evaluation of 240 cases

BackgroundMinor salivary glands can be found in the ventral and anterior part of the tongue; these glands can rarely develop mucoceles that, due to their rarity and their unusual clinical appearance, may present an interesting differential diagnosis. Mucoceles appear as an exophytic, sometimes pedunculated, lesion, which is a feature that is due to the absence of a capsule; thus, the glands are right beneath the mucosa and over the muscle tissue. The aim of this article is to retrospectively present and discuss the anatomy, pathology, clinical features and therapy of several cases of Blandin-Nunh mucoceles collected from two different institutions.MethodsA retrospective case review was carried out in two university institutions, retrieving all cases of tongue mucoceles from 1999 to today. Two oral pathologists reviewed all the slides, confirming the diagnosis. Demographic data of the patient, anatomic location and clinical appearance were retrieved from clinical charts, together with the type of surgical procedure and possible relapses.ResultsA total of 240 cases of tongue mucoceles were gathered from the archives: the mean age was 22 years (DS = 14,7; Range 2–83), 126 were females (52,5%, mean age 22,7 years, DS = 16,5; Range 2–83), and 114 were males (47,5%, mean age 20,9 years, DS = 12,4; Range 3–73); in all cases, a history of trauma was reported. The ventral surface was the most frequent location (224 cases – 93,3%), and in the great majority (235 cases – 97,9%), pathology revealed mucous spillage with a wall formed by fibrous connective and granulation tissue with no epithelium lining the cavity. Superficial mucocele and sclerosing sialoadenitis were the more frequent pathological variants (21 cases – 8,8%). All lesions were treated with excision and enucleation of the servicing gland. The healing was uneventful in all cases, but there were four recurrences and two cases of sensory paraesthesia of the border of the tongue, all in males, except one case of paraesthesia in a female.ConclusionsTongue mucoceles must be differentiated from many benign and malignant lesions. For this reason, surgical removal of the lesion and of the associated gland with a pathological exam is mandatory. In fact, the anatomical location of the glands and the possible pathological variants must be considered to reach a correct diagnosis and diminish possible relapses.Trial registrationCE-Muc_Ton_3/2023.

Diagnostic challenges of superficial mucoceles: An update.

A superficial mucocele is a unique variant of a mucocele of the oral cavity that was described by Eveson for the first time in 1988. It occurs due to subepithelial extravasation of sialomucin at the epithelial-connective tissue interface and is related to damage of the minor salivary gland ducts. Clinically, they appear as small, asymptomatic, clear, tense vesicles with a predilection for the soft palate, retromolar pads, and posterior buccal mucosa. They are reported to occur more frequently in women than in men. Before Eveson endeavoured to describe these rather peculiar lesions, they were often misdiagnosed as vesiculobullous lesions such as bullous lichen planus, mucous membrane pemphigoid, and the like. It is incumbent on the present-day pathologist to be cognizant of the presence of these entities as it could present a formidable diagnostic challenge otherwise. This review gives an updated account on the etiology, prevalence, clinical features, differential diagnosis, and management of superficial mucoceles.

Clinical characteristics of oral chronic graft-versus-host disease according to the 2014 National Institutes of Health (USA) consensus criteria.

Chronic graft-versus-host disease (cGVHD) is a serious and common complication of allogeneic hematopoietic cell transplantation (alloHCT). The oral cavity is the second most common site affected by cGVHD. In 2014, the 2005 National Institutes of Health (NIH) consensus criteria were revised to address areas of controversy. The aim of this study was to evaluate the clinical characteristics of oral cGVHD using the 2014 NIH consensus criteria. The baseline data of oral manifestation of patients, who were diagnosed with oral cGVHD, in the first dental visit were analyzed (n=22). The oral mucosal disease was evaluated by NIH modified Oral Mucosa Rating Scale (OMRS) and Thongprasom sign score. The salivary gland disease and sclerotic disease were determined by the presence of signs and symptoms. The functional impact was assessed by the organ-specific severity score. The median time from transplant to oral cGVHD diagnosis was 11.9 months. White striae with an erosive area was found in 72.7% of the patients. The mean ± SD of NIH modified OMRS was 6.1 ± 3.0. The most common and severely affected site of lichen planus-like features was buccal mucosa. Xerostomia, superficial mucocele and limited mouth opening were found in 18.2%, 9.1%, and 9.1%, respectively, of the patients. Almost all patients (90.9%) had partial limitation of oral intake. There were no significant differences in NIH modified OMRS or organ-specific severity score among the patient characteristic groups. Moreover, there was no association between the oral manifestations of cGVHD and the patient characteristics. The most common oral manifestation of cGVHD was white striae with an erosive area of oral mucosal disease, followed by xerostomia, superficial mucocele, and limited mouth opening. The 2014 NIH consensus criteria for diagnostic and severity assessment are informative and feasible in real-world practice.

Managing Superficial Mucocele: Case report

Superficial mucocele (SM) is a very rare lesion. We report a unique case of the lesion occurring only on one side of the soft palate in a 37 year old female who exhibited a high level of IgE due to allergy to house mites. Diagnosis of the lesion could be confidentally arrived at by clinical and histologic examinations, as it has been confused with bullous lichen planus, pemphigoid and viral diseases. The pathogenesis remains debatable, though claims of being associated with trauma, radiation, allergy, lichen planus, Graft-Versus-Host-Disease, and mycoplasma have been made. Past treatments varied from excission, y-linolenic acid, cryosurgery, cyclosporine and steroids. Many believed SM resolves spontaneously and no treatment is warranted. However, there are cases known to last for months and caused great stress and discomfort. Our patient remitted within four months of treatment with combinations of steroids, anti-histamines and reassurance of the true nature of the lesions. Till today, though cured, our patient is very apprehensive of recurrence.

Superficial mucoceles in cancer patients: a retrospective series from a Stomatology unit.

The aim of this study is to relate all the superficial mucoceles found in a cancer center, described the association with oncological conditions, and discuss its etiology and pathology that we found in the past few years. Sixteen cases of superficial mucocele were retrieved from the patients' records of the Stomatology Department of the A. C. Camargo Cancer Center, São Paulo, Brazil, and demographic and clinical data were collected from electronic medical records. There were 16 patients, 8 patients were men and 8 women, with ages varying from 26 to 70 years old. Superficial mucoceles were observed in patients submitted to head and neck radiotherapy (n=6), graft versus host disease (n=4), one associated with oral mucositis related to allogenic bone marrow stem cells transplantation (n=1), systemic lupus (n=1), Sjögren's syndrome (n=1), oral lichenoid lesion associated with pembrolizumab (n=1) and no local or systemic inflammatory associated found (n=2). This study reports a series of superficial mucoceles from a single stomatology unit. Most patients had superficial mucoceles secondary to head and neck radiotherapy and graft versus host diseases. However, two patients (12.5%) had mucoceles related to systemic inflammatory conditions (Sjögren's Syndrome and Systemic Lupus).

A Case of Superficial Mucocele Induced by L-Carbocisteine

A Case of Superficial Mucocele Induced by L-Carbocisteine

Oral mucocele: A clinicopathological analysis of 50 cases

Background: Mucocele belongs to the category of reactive lesions affecting the salivary gland related to obstruction or trauma of the salivary glands. These are pseudocysts formed due to the accumulation of pooled mucus. Objectives: To evaluate the clinicopathologic features including variations of 50 oral mucocele cases Materials and Methods: Archival review for the 50 cases reported as mucoceles was performed, and data for the following parameters were recorded: Age, gender, history of trauma, site and clinical presentation, variation in histology, treatment mode, and recurrence. Results: A total of 50 cases of mucoceles were retrieved for the archives for study. All were extravasation phenomenon (100%), no retention phenomenon was found, seen in the second (36%) and third (46%) decade, with male preponderance (male:female 19:6). Most common locations were lower lip (96%), floor of the mouth (6%), and ventral tongue (4%). Commonly presented as soft, fluctuant, bluish swelling associated with history of trauma. Variations included superficial mucocele (10%), clear cell change (4%) and papillary infoldings (2%) and 6% of recurrence cases. Conclusion: Although it is a benign lesion which is commonly encountered and excised in dental practice, the classic clinical presentation of soft, fluctuant swelling accompanied by history of evolution of the lesion does not pose much difficulty in diagnosis. Special variants of oral mucoceles occur infrequently; it is important to recognize these variants to avoid misdiagnosis, it is always wise to subject it to histopathological confirmation owing to its close clinical resemblance to neoplastic condition.

Mucocele: An unusual presentation of the minor salivary gland lesion

A mucocele is a benign, mucus-containing cystic lesion of the minor salivary gland. This type of lesion is most commonly referred to as mucocele. The more common is a mucus extravasation cyst; the other is a mucus retention cyst. Other three clinical variants are: Superficial mucocele that is located directly under the mucosa, classic variant located in the upper submucosa, and deep mucocele located in the lower cornium. Mucocele occurs either due to rupture of salivary gland duct or by blockade of salivary gland duct. The common site of occurrence of mucocele is lower lip followed by tongue, floor of mouth (ranula), and the buccal mucosa.

Mucocele superficial em lábio inferior: relato de caso

Mucoceles são cistos mucosos relacionados com a obstrução ou trauma das glândulas salivares menores. Preferencialmente, estão localizadas no lábio inferior, palato mole, região retromandibular e mucosa oral. Microscopicamente, constituem-se em extravasamento subepitelial de sialomucina, que ocorre na interface do tecido epitelial conectivo. O diagnóstico da mucocele superficial é principalmente clínico, sendo raramente indicada a realização de biópsia. Este artigo descreve uma lesão em lábio inferior cujo diagnóstico definitivo foi de mucocele, ou fenômeno de retenção de muco.

Case of superficial mucocele of the lower lip

Superficial mucocele is a relatively rare bullous disease that develops in the oral mucosa. Although the number of reported cases is limited, it seems that the superficial mucocele has been recognized as an independent disease belonging to a single entity. We report a 48-year-old woman who repeatedly developed superficial mucocele in the oral mucosa. When she was admitted to our hospital she had a tense vesicle on her lower lip. A skin biopsy was taken from the vesicle. A blister containing neutrophils and erythrocytes was present in the mucous epithelium. There was a dermal infiltrate comprising neutrophils, mononuclear lymphocytic cells and eosinophils. Dilated salivary gland excretory ducts were seen in the lamina propria mucosae. Eosinophilic and amorphous materials, which were periodic acid-Schiff positive after digestion with diastase, and alcian blue positive, were deposited in the blister. Direct immunofluorescence was negative for immunoglobulin (Ig)G, IgM, IgA, C1q, C3 and C4. These histological findings led us to make a diagnosis of superficial mucoceles.

Recurrent Superficial Mucoceles Associated With Lichenoid Disorders

Mucoceles are lesions of the oral cavity caused by salivary retention or extravasation from the minor salivary glands.1,2 They appear as bluish nodules, preferentially localized on the lower lip and the mouth floor. In 1988, Eveson3 described a new clinical entity termed superficial mucocele, presenting as either single or multiple, small, translucent, painless, recurrent vesicles. Since then some rare cases have been reported in the literature.4-8 In 2 series of cases of recurrent superficial mucoceles (RSM) published, an association with oral lichen planus (OLP) was described.

表在性粘液嚢胞の２例

Superficial mucocele is a variant of the commonly encountered classic type of mucocele. Clinically, it is a small, innocuous, clear, tense vesicle that has a predilection for the soft palate, retromolar region, and buccal mucosa. Histopathologically, it is characterized by extravasation of mucus into the tissues immediately below the epithelium. A few cases of superficial mucocele have been reported, and the lesion has been occasionally misdiagnosed as subepithelial vesiculating disorders such as bullous lichen planus, mucous membrane pemphigoid, or herpes simplex infection. Two cases of superficial mucocele are presented. The first patient was a 47-year-old woman. Multiple vesicles 1 to 3 mm in diameter were observed on her lower lip, buccal mucosa, retromolar region, and soft palate. The second patient was a 45-year-old woman presenting with recurrent small vesicles on the soft palate. Biopsy showed that these lesions had histologic features consistent with those of mucocele. On the basis of clinical findings, superficial mucocele was diagnosed. Differences from common mucocele and the pathogenesis and differential disgnosis of this rare lesion are described.

Superficial mucocele: Report of 4 cases

Four cases of the lesion first described as superficial mucocele by Eveson in 1988 are reported. All of the lesions developed in adult women; two of the women had concurrent oral lichen planus. The mucoceles were found on the soft palate, the buccal mucosa, and the upper and lower labial mucosa. The etiologic factors and pathogenesis of this lesion are discussed. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:469-72)

Benign Lesions of the Oral Cavity

The superficial mucocele is a rare variant of the common mucocele and noted microscopically by subepithelial pools of mucin. To increase the understanding of oral superficial mucoceles, a database was created from the demographics of case reports and case series from a PubMed search. At least 200 patients with superficial mucoceles have been described in the English-language literature, 82 of whom had biopsy-proven lesions; additional clinical information was available for 39 of these 82 patients. Compiled data suggest superficial mucoceles offered phenotypic distinctions from the common mucocele because they were more apt to occur in middle-aged women, often on the soft palate and buccal mucosa. Affected patients frequently had multiple lesions that were smaller than 3 mm and nearly 50% of patients developed recurrence. This report also describes the first histopathologically confirmed case of a superficial mucocele arising on the ventral tongue in a 22-year-old man. It is speculated that the glossal lesion might have developed from long-term impingement from exposed metal barbs from an orthodontic splint. Persistent lesions or atypical presentations underscore the need for histopathologic examination.