Senin, 31 Oktober 2011

Mucocele, Ranula and Dermoid cyst-Short note

Mucocele of lower lip

Mucocele of Tongue

Definition Mucoceles, or mucous cysts, are a common phenomenon or lesion of the oral mucosa, originating from minor salivary glands and their ducts.

Etiology Local minor trauma and duct rupture or ductal obstruction, probably due to a mucous plug.

Clinical features Two main types of mucocele are recognized, according to their pathogenesis: extravasation mucocele (common), which results from duct rupture due to trauma and spillage of mucin into the surrounding soft tissues; and mucous retention cyst (uncommon), which usually results fromductal dilation due to ductal obstruction. 

Clinically, mucocele presents as a painless, dome-shaped, solitary, bluish or translucent, fluctuant swelling that ranges in size from a few millimeters to several centimeters in diameter. A common finding is that the cyst partially empties and then re-forms due to the accumulation of new fluid. The lower lip is the most common site of involvement, usually laterally, at the level of the bicuspids. Less common sites are the buccal mucosa, tongue, floor of the mouth, and soft palate. Extravasation mucoceles display a peak incidence during the second and third decades, while the mucous retention types are more common in older age groups.

Laboratory tests Histopathological examination.

Differential diagnosis Lymphangioma, hemangioma, lipoma, mucoepidermoid carcinoma, Sjögren syndrome, lymphoepithelial cyst.

Treatment Surgical excision or cryosurgery.


Definition Ranula is a formof mucocele that occurs exclusively on the floor of the mouth.

Etiology Trauma or ductal obstruction.

Clinical features It presents as a smooth, fluctuant, painless swelling on the floor of the mouth, lateral to the midline. The color ranges fromnorm al to a translucent bluish, and the size is usually in the range of 1–3 cm, or larger. The diagnosis is usually based on clinical  criteria.

Laboratory tests Histopathological examination.

Differential diagnosis Dermoid cyst, abscess, hemangioma, lymphangioma, lymphoepithelial cyst.

Treatment Surgical removal or marsupialization.

Dermoid Cyst
Dermoid cyst

Definition and etiology Dermoid cyst is an uncommon developmental cystic lesion arising from embryonic epithelial remnants.

Clinical features It presents as a slow-growing, painless swelling with a normal or yellowish-red color and a characteristic soft dough like consistency on palpation. The size varies from a few millimeters to 10 cm in diameter, and the lesion usually occurs in the midline of the floor of the mouth. If the cyst is located above the geniohyoid muscle, it can displace the tongue upward and create difficulty in mastication, speech, and swallowing. When the cyst occurs below the geniohyoid muscle, it may protrude submentally. Rarely, dermoid or epidermoid cysts may develop in the lips. The cyst frequently appears in early adulthood.

Laboratory tests Histopathological examination.

Differential diagnosis Ranula, abscess, lymphoepithelial cyst, cystic hygroma.

Treatment Surgical removal.

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