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Oral mucoceles are lesions arising mainly from the minor salivary glands and are thought to occur after excretory duct trauma. We report a case of multiple superficial oral mucoceles on a child's labial mucosa after Mycoplasma pneumoniae mucositis. Mucoceles can mimic persistent or recurrent stomatitis and lead to potential errors in management., (© 2018 Wiley Periodicals, Inc.)

Mucocele-like lesions of the breast diagnosed on core biopsy are usually excised to exclude the possibility of partial sampling of an invasive mucinous carcinoma. The goal of this study was to correlate the pathologic and radiologic features of mucocele-like lesions to determine if excision is mandatory. Over a 16 year period we identified 32 patients with mucocele-like lesions diagnosed on 27 (84%) stereotactic and 5 (16%) ultrasound-guided core biopsies. The indications for core biopsy were: calcifications in 24 (75%), a mass in 7 (22%), and a mass with calcifications in 1 (3%). There were 22 (69%) mucocele-like lesions without atypia and 10 (31%) with atypical ductal hyperplasia or detached groups of atypical cells. Of the 22 mucocele-like lesions without atypia, 19 (86%) were excised: 15/19 (79%) were benign, 3/19 (16%) had atypical ductal hyperplasia and 1/19 (5%) had ductal carcinoma in situ. None of the patients with mucocele-like lesions without atypia were upgraded to invasive carcinoma. The single patient who was upgraded to low-grade ductal carcinoma in situ had a history of ductal carcinoma in situ in the same breast. Of the 10 patients with mucocele-like lesions with atypia, 9 (90%) were excised: 5/9 (56%) were benign, 1/9 (11%) had atypical ductal hyperplasia and 3/9 (33%) had invasive carcinoma. Of the patients with mucocele-like lesions with atypia who were upgraded to invasive carcinoma, one had a BIRADS 5 mass and discordant pathology and one had a history of Hodgkin lymphoma and mantle radiation. There were 24 patients with mucocele-like lesions with or without atypia who were not upgraded on excision, and none developed breast cancer after a median of 51 months (range 7-192). These findings indicate that mucocele-like lesions without atypia are unlikely to be upgraded on excision and are associated with a low risk for the subsequent development of carcinoma., (© 2017 Wiley Periodicals, Inc.)

Management of pure mucocele-like lesion (MLL) diagnosed on percutaneous breast biopsy (PBB) is controversial. To assess surgical upgrade rate and clinical outcome of pure MLL obtained as sole diagnosis on PBB. Patients diagnosed with a MLL as the most advanced lesion on PBB from April 1997 to December 2010 were reviewed for radiologic presentation, biopsy technique, and pathologic and clinical outcomes. Of the 21,340 image-guided PBB performed during the study period, 50 women with 51 MLL (0.24%) were identified. Mean age was 53.1 ± 7.7 years. Radiologic findings were mostly microcalcifications (n = 47, 92.2%). Stereotactic PBB was performed for 49 lesions (96.1%). Surgery was performed shortly after biopsy in 35 women, with benign final pathology in 33, and upgrade to ductal carcinoma in situ (DCIS) in two patients (2/35, 5.7%). Mean follow-up was 4.2 ± 2.5 years (3.7 ± 2.1 years for surgical patients; 5.9 ± 2.9 years for follow-up only patients); three women were lost to follow-up (3/50). Three invasive cancers (3/47, 6.4%) were diagnosed 1.2, 1.2, and 2.8 years after biopsy: two in surgical patients, and one in a follow-up only patient. No cancer occurred at the same site as the original MLL. Pure MLL lesion of the breast is a rare entity and is mostly associated with a benign outcome. We observed an upgrade to DCIS slightly superior to 5%, but no invasive cancer. It is therefore unclear if these lesions should be excised or clinically and radiologically followed up when such lesions are found at PBB., (© 2015 Wiley Periodicals, Inc.)

Background: Mucoceles are common cystic lesions of the oral mucosa. Extravasation mucoceles (EMs) are mainly found in the lower lip of young patients, whereas retention mucoceles (RMs) are usually located in the cheek or palate of older patients. This study was undertaken to more fully characterize the clinicopathologic features of mucoceles in pediatric patients., Methods: The records of 56 pediatric patients with mucoceles were included in the study. Age, sex, history of trauma, intraoral site, size, and method of treatment were evaluated. Histopathologically the lesions were classified as being EMs or RMs., Results: The age range was 1.5 to 16 years (mean age 11.2 yrs). Of the 56 patients, 24 (43%) were males and 32 (57%) were females, with a male:female ratio of 1:1.33. A history of trauma was recorded in 32 (57%) patients of the lower lip. The intraoral sites were the lower lip (38 [68%]), tongue (10 [18%]), and floor of the mouth (8 [14%]). Of the 56 patients, 44 (79%) were EM and 12 (21%) were ranulas. No RMs were found. Mucoceles ranged from 0.3 to 3.8 cm in diameter (mean 0.9 cm). The treatment of EMs was surgical excision. Cryosurgey, electrosurgery, and carbon dioxide laser were also used., Conclusion: In contrast to adults, where EM and RM types can be found, among children all cases are of the EM type. The disparate site and age incidences of EMs and RMs of the oral mucosa suggest that these two types are not related and possibly have a different etiopathogenesis., (© 2015 Wiley Periodicals, Inc.)

Oral mucoceles are common lesions that normally appear in the second decade of life. They are uncommon in neonates and infants. We present a case of a mucocele in a 10-month-old infant and review the literature regarding the epidemiology and treatment in this age group., (© 2013 Wiley Periodicals, Inc.)

Objective: The goal of this study was to investigate how patency of the nasofrontal outflow tract would affect frontal sinus healing in the setting of displaced, comminuted, posterior table fractures in the adult goat (Capra hircus)., Study Design: Prospective animal study., Subjects and Methods: Posterior table fractures were created in 20 adult goats. The nasofrontal outflow tract was left patent in 10 goats (Group 1) and obstructed in 10 (Group 2). Gross, radiologic, and histologic evaluation were carried out six months postoperatively., Results: One of nine subjects subjects (11%) in Group 1 developed a mucocele while eight of 10 (80%) in Group 2 developed mucoceles (P = 0.004). No subjects (100%) in Group 1 had gross, radiologic, or histologic evidence of mucosal ingrowth into the posterior table, while two of 10 (20%) in Group 2 showed evidence of mucosal ingrowth into, but not through, the posterior table. In both groups 100% of the subjects had gross and histologic evidence of intact posterior tables abutting the dura., Conclusion: An occluded nasofrontal outflow tract leads to an increased mucocele formation rate at six months. In an unobstructed nasofrontal outflow tract there is no gross, radiologic, or histologic evidence of mucosal ingrowth into the posterior table at six months. These findings would suggest that not all comminuted, significantly displaced posterior table fractures need to be surgically addressed if the nasofrontal outflow tract is patent.

Objective: The objective of this study was to review the management of paranasal sinus mucoceles with skull-base and/or orbital erosion in the endoscopic era., Study Design: A retrospective data analysis., Methods: A chart review was performed on 57 patients treated from January 2001 to March 2007., Results: The average age at the time of presentation was 50.6 years with a 1:1 male: female ratio. The most common site was the frontal sinus (54.4%), followed by frontoethmoid (29.8%) and sphenoid (8.8%). Areas of erosion included skull base (40.4%), orbit (50.9%), and both orbit and skull base (8.8%). Endoscopic drainage using image guidance was used in all 57 patients without complications. Fifty-six cases (98.2%) had a functionally patent mucocele opening with a median follow-up of 15 months., Conclusions: The endoscopic approach can be safely used for the management of mucoceles with skull-base and/or orbital erosion. Open adjunct approaches can be avoided in most cases.

Mucoceles are common benign lesions of the oral cavity that develop following extravasation or retention of mucous material from major or minor salivary glands. Most series report a higher incidence of mucocele in young patients but no studies exist for this specific age group. The records of 104 patients presenting with mucocele who underwent surgery in the Oral Diseases Clinic of the Department of Dermatology of the University of São Paulo, Brazil, between 1991 and 2006, were reviewed. Of these, 36 (34.6%) were 15 years old or younger, the youngest being 2 years old. Twenty-six patients were girls, 10 were boys. Lesions were located on the lower labial mucosa (30 patients), tongue (three), floor of the mouth (one), buccal mucosa (one), and in one patient the location was unknown. Histopathology revealed an extravasation pattern in 35 patients and a retention pattern in one. Of the distinct subtypes of mucocele, tongue lesions (mucocele of the glands of Blandin-Nuhn) seem to be more prevalent and retention mucoceles seem to be very rare in children.

Collagenous spherulosis is a histological pattern that has been described in both benign and malignant salivary gland tumors, proliferative lesions of breast ductal epithelium, chondroid syringomas and schwannomas. Histologic structures of similar appearance have also been reported in oral extravasation mucoceles as questionable myxoglobulosis or myxoglobulosis-like change. We report collagenous spherulosis within a mucocele removed from the lower lip of a 17-year-old female. Based upon histologic appearance, immunophenotypic data and review of the literature, we hypothesize that collagenous spherulosis and myxoglobulosis are morphologically related reaction patterns.

Objective: To evaluate the difference in anatomical and invasive characteristics of primary and secondary paranasal sinus mucoceles., Study Design: A retrospective chart review at a tertiary academic center., Results: During a 10-year period, 57 and 109 patients with primary and secondary mucoceles were enrolled, respectively. Thirty-five (61.4%) of primary and 26 (23.9%) of secondary mucoceles had intraorbital extension (IOE), while seven (12.3%) of primary and two (1.8%) of secondary mucoceles had intracranial extension (ICE). In comparison of tendency for IOE or ICE between primary and secondary mucoceles in each sinus, only primary maxillary mucoceles were shown to have a significantly higher probability of IOE than secondary maxillary mucoceles. Among primary mucoceles, ethmoid mucoceles had a significantly greater capability to cause IOE while maxillary mucoceles had the least. Among secondary mucoceles, frontal and ethmoid mucoceles had a greater ability to cause IOE while maxillary mucoceles had the least. As for ICE, sphenoid mucoceles had a greater potential in both groups., Conclusions: Primary mucoceles seem to have a greater potential to cause IOE and ICE than secondary mucoceles. In both groups, ethmoid mucoceles have a higher potential of IOE, while sphenoid mucoceles have a greater tendency to cause ICE.

It is recommended that mucocele-like lesions be excised to enable differentiation between benign lesions and carcinoma. In addition, ductal carcinoma in situ may be found in close association. A small series of 12 lesions audited at BreastScreen Auckland has shown six benign, one atypical, and five malignant lesions. Although this is a small series, a high rate of associated malignancy has been reported.

We describe a 59-year-old male patient noted to have bilateral oncocytic cysts of the nasopharynx. These cysts appear to represent retention cysts of peritubal mucoserous glands that have undergone oncocytic metaplasia and would be classified as lateral acquired cysts of the nasopharynx. These cysts are benign but may cause symptoms related to their location in the airway and proximity to the eustachian tube. Endoscopic surgical removal is the treatment of choice.

Background: The current understanding of appendiceal epithelial tumors is based on series composed of relatively small numbers of patients and on case reports. The aim of this study was to perform clinicopathologic correlation, particularly concerning prognosis, on a relatively large series of patients with epithelial tumors and tumor-like lesions of the human vermiform appendix., Methods: One hundred eighty-four cases of simple mucoceles, hyperplastic polyps, adenomas, carcinomas, and mucinous tumors of uncertain malignant potential (UMP) were reviewed. Retrospective follow-up data were obtained in carcinoma and UMP tumor cases., Results: Most neoplasms were of the mucinous type characteristic of the appendix, but a small fraction were nonmucinous and resembled neoplasms typical of the spectrum encountered in the colorectum. Both benign and malignant conditions in some cases showed acellular mucin dissecting the appendiceal wall and mucin outside the appendix. Immunostains were sometimes helpful in identifying epithelial cells within mucus, but hematoxylin and eosin and mucin stains were adequate in most cases. Two factors were significantly associated with survival by multivariate analysis: the presence of mucin outside the right lower quadrant of the abdomen and the presence of epithelial cells in the peritoneal cavity outside the appendix., Conclusions: The distribution of mucin within the abdomen and the presence of cells outside the visceral peritoneum of the appendix are important prognostic factors that should be recorded in these neoplasms. Tumors designated as UMP lesions behave in a benign or low grade fashion.

Mucoceles of the paranasal sinuses are benign, expansile, locally destructive lesions that are thought to occur secondary to obstruction of the sinus ostia. Nasal and/or ocular signs and symptoms are the usual clinical manifestations of mucoceles arising in the ethmoid and sphenoid sinuses, and intracranial extension is rare. We describe three cases of widely destructive sphenoethmoidal mucoceles extending intracranially, with bone erosion and dural exposure in all cases and brain necrosis in one case.

Carcinomas of the nasal cavity and paranasal sinuses are statistically dominated by squamous-cell lesions, which account for between 85% and 90% of the epithelial malignancies in these sites. Neoplasms of glandular derivation are far less frequent, accounting for between 4% and 8% of carcinomas in this region. Both classes of malignancy, however, indicate an ominous prognosis for their hosts, and for both, it is the extent of the cancer, and hence the clinical stage, that is the major determinant. The clinicopathologic characteristics of squamous-cell and glandular carcinomas of the nasal cavity and paranasal sinuses are presented, and for the latter, a review of their presentation in the larynx is also offered.

A study of primary epithelial neoplasms of the appendix (with the exception of classical carcinoids), produced 24 adenocarcinomas and 42 benign lesions from the files of the Laboratory of Surgical Pathology of Columbia University. Invasive adenoarcinomas were often complicated by appendicitis and were then unexpectedly discovered during appendectomy. In one third of the cases the carcinomas were found in juxtaposition to adenomatous lesions of the appendix. Well-differentiated adenocarcinomas of the colonic type generally had a better prognosis than signet-ring cell (or microglandular) tumors. The most reliable criterion for correlating prognosis was the Duke's method of staging. Since invasive adenocarcinomas of the appendix can metastasize to regional lymph nodes, treatment should ideally consist of ileocolectomy.

The A-mode ultrasound is an inexpensive and efficacious screening modality for sinus pathology. A comparison of 690 ultrasound patterns from 200 cases was made with sinus x-ray films and case histories. Excellent correlation was found between the ultrasound patterns and the subsequent diagnosis of a normal sinus or a pathologic sinus containing fluid, thickened mucosa, or a mass. Future areas of potential clinical usefulness and current limitations of this instrument are discussed.