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A survey of natural mucoceles revealed that there were two types, namely, extravasation and retention, and that extravasation mucocceles occurred most often in younger patients and in the lower lip, whereas retention mucoceles occurred most often in older patients and elsewhere in the mouth.

A case of cutaneous salivary fistula and sialocele in the submental area, arising from the sublingual gland, is reported and its etiology, development, and management are discussed. The entity of plunging ranula is compared to the lesion the case presented, and the literature regarding this lesion is reviewed. The successful surgical treatment of this case supports the theory that the sublingual gland is the source of the disorder. The effect of the altered salivary function on the adjacent submandibular gland and duct presented an operative complication.

The dome-shaped radiopaque shadows frequently seen on the floor of the maxillary sinus, and sometimes inaccurately referred to as antral mucoceles, appear to represent focal accumulation of inflammatory exudate that lifts the epithelial lining of the sinus and the periosteum away from the underlying bone to form the characteristically shaped structures. Their histologic appearance is therefore that of normal or inflamed maxillary sinus lining. There is no epithelium-lined cavity present beneath the sinus mucosa; consequently, the term pseudocyst of the maxillary sinus is advocated. Less commonly, epithelium-lined retention cysts, similar to those of the minor salivary glands, are found, but mucoceles of the type found in the oral cavity apparently do not occur in the maxillary sinus.

While mucoceles of the oral mucosa are relatively common, multiple mucous retention cysts have not previously been reported. In this article two such cases, in which numerous minor salivary gland ducts had dilated to the point of cyst formation, are described. The number of individual cysts exceeded 100 in each case. Since it is clear that these cysts formed as a result of dilatation of salivary ducts, it would seem that either the ducts were blocked by altered secretion or there was an acquired or congenital weakness in their structure.

Antral mucoceles are a separate entity that must be distinguished from the common, dome-shaped lesions of the floor of the sinus that are also often, although inaccurately, referred to as mucoceles. The latter lesions are known by a variety of names, including pseudocysts, and are innocuous. True antral mucoceles are potentially destructive lesions that are often secondary to trauma, especially the Caldwell-Luc procedure. This article describes in some detail the clinical, radiologic, and histopathologic features of true antral mucoceles. One type of antral mucocele, commonly seen in Japan, is referred to as a postoperative maxillary cyst and is identical to the surgical ciliated cyst of the maxilla originally reported by Gregory and Shafer.

The maxillary sinus mucocele occupying the entire sinus is rarely reported by dentists. This article discusses one such case diagnosed as an exceptionally large maxillary sinus cyst occupying the whole sinus. Unlike their findings in the medical literature, the authors were unable to find many similar cases reported in the dental literature. The location of these mucoceles necessitates the use of diagnostic radiographs, especially those of the panoramic type. Because etiology is still not fully understood after almost 100 years, the authors suggest and discuss four possible mechanisms of sinus mucocele formation and growth.

This article presents several cases of two types of yellow lesions of the tonsils. The bacterial plug is a small, sometimes symptomatic lesion composed of mats of bacteria that fill a tonsillar crypt and is treated by dislodging the plug. The pseudocyst is a small, mostly asymptomatic smooth, epithelium-covered lesion that can regress spontaneously and need not be surgically removed for diagnosis. Both lesions are compared and contrasted to delineate diagnostic features and to suggest management. Terms are differentiated, and the relationship to the lymphoepithelial cyst is discussed.

Extravasation mucoceles can be so superficial that they are seen as subepithelial blisters. These may rupture and cause superficial painful ulcers, which usually heal quickly. Occasionally such lesions may be seen in association with other mucosal disorders, particularly lichen planus, and a biopsy is undertaken to establish the diagnosis. In addition, the reporting pathologist may make an erroneous diagnosis of a subepithelial vesiculating disorder such as mucous membrane pemphigoid, especially when the clinical history is vague. Eight cases are described that illustrate some of the pitfalls in clinical and microscopical diagnosis of superficial mucoceles.

An unusual case of a mucous extravasation cyst that manifest itself solely as a cervical swelling is reported. As a result of this unusual symptom, diagnosis and appropriate treatment were delayed, and the condition finally resolved after the ipsilateral sublingual salivary gland was excised and the cervical fluid was aspirated. Cervical mucoceles have also been reported in dogs, and the veterinary literature pertaining to this is briefly reviewed.

Ultrasonographic examination of masses in the neck can be a valuable diagnostic aid. It has the advantages of being noninvasive, rapid, easily repeated, and relatively inexpensive. Ultrasound is also a particularly convenient means of localizing lesions for percutaneous biopsy and for serially monitoring the response of a lesion to therapy. As experience increases and equipment improves, ultrasound will gain an even greater role as a diagnostic aid. A case is reported in which a mucus-retention phenomenon was evaluated, managed, and followed with the aid of B-scan ultrasonographic and real-time imaging.