Dermatologic Manifestations of Mucous Cyst Treatment & Management
- Author: Christopher R Shea, MD; Chief Editor: William D James, MD more...
Patients with asymptomatic, superficial mucous cysts may require reassurance only. Partial or total electrodesiccation and intralesional injections of triamcinolone acetonide have been reported as treatments for mucous cysts. Topical clobetasol propionate 0.05% has been reported as an effective intervention for multiple, recurrent mucous cysts.
For definitive management, if indicated, the minor salivary gland may be excised, just as in cases with persistent irritation.
The treatment of choice for a deep mucous cyst and the classic form is surgical excision, which should include the immediate adjacent glandular tissue.
Cryosurgery with liquid nitrogen spray or cryoprobe is an alternative therapeutic modality.[21, 22] After day 4 to week 1, a necrotic surface is observed in the treated area. The latter separates from the surrounding mucosa in 1-2 weeks, exposing a new epithelialized surface. The advantages of the procedure include a simple application, minor discomfort during the procedure, and a low incidence of complications (eg, secondary infection, hemorrhage); however, the possibility of recurrence exists.
Another therapeutic strategy is argon laser treatment, typically administrated at a constant pulse duration of 0.3 seconds, using a laser beam diameter of 1.5-2 mm and a power setting of 2-3 W. Lesions presenting as firm nodules are treated with a continuous exposure and a power setting of 2.5-3.5 W. The necrotic area posttreatment is well defined by day 8-12, with complete wound healing in approximately 2 weeks. The only reported complications are swelling and mild discomfort for up to 10 days. The advantages of argon laser over cryosurgery consist of less discomfort in the postoperative period, less edema and irritation, and a reduced healing time. A disadvantage of this therapeutic alternative is the requirement of specialized equipment.
The use of carbon dioxide laser appears to be a superior treatment modality for mucous cyst, with minimal recurrence. It has the advantages of allowing precise surgical technique, lack of bleeding for a clear operation field, minimal wound contraction and scarring, and a short operative time.[25, 26, 27] As such, it has been proposed to be particularly useful in the treatment of those who are intolerant of long procedures, including children. A disadvantage is the requirement of expensive, specialized equipment, and necessary protection for both the patient and physician performing the laser vaporization.
Erbium laser treatment has also been described in a pediatric patient, with excellent results.
Diode laser vaporization (940 nm in contact mode) was used successfully in one reported patient with an extravasation-type mucous cyst of the lower lip.
Possible consultations may include the following:
Oral medicine specialist
Oliveira DT, Consolaro A, Freitas FJ. Histopathological spectrum of 112 cases of mucocele. Braz Dent J. 1993. 4(1):29-36. [Medline].
Chaudhry AP, Reynolds DH, Lachapelle CF, Vickers RA. A clinical and experimental study of mucocele (retention cyst). J Dent Res. 1960 Nov-Dec. 39:1253-62. [Medline].
Kundu S, Cheng J, Maruyama S, Suzuki M, Kawashima H, Saku T. Lymphatic involvement in the histopathogenesis of mucous retention cyst. Pathol Res Pract. 2007. 203(2):89-97. [Medline].
Martins-Filho PR, Santos Tde S, da Silva HF, Piva MR, Andrade ES, da Silva LC. A clinicopathologic review of 138 cases of mucoceles in a pediatric population. Quintessence Int. 2011 Sep. 42(8):679-85. [Medline].
Chi AC, Lambert PR 3rd, Richardson MS, Neville BW. Oral mucoceles: a clinicopathologic review of 1,824 cases, including unusual variants. J Oral Maxillofac Surg. 2011 Apr. 69(4):1086-93. [Medline].
Bouquot JE, Gundlach KK. Oral exophytic lesions in 23,616 white Americans over 35 years of age. Oral Surg Oral Med Oral Pathol. 1986 Sep. 62(3):284-91. [Medline].
Yamasoba T, Tayama N, Syoji M, Fukuta M. Clinicostatistical study of lower lip mucoceles. Head Neck. 1990 Jul-Aug. 12(4):316-20. [Medline].
Vale EB, Ramos-Perez FM, Rodrigues GL, Carvalho EJ, Castro JF, Perez DE. A review of oral biopsies in children and adolescents: A clinicopathological study of a case series. J Clin Exp Dent. 2013 Jul 1. 5(3):e144-9. [Medline]. [Full Text].
Shapira M, Akrish S. Mucoceles of the oral cavity in neonates and infants--report of a case and literature review. Pediatr Dermatol. 2014 Mar-Apr. 31(2):e55-8. [Medline].
Silva IH, Cardoso S, Carvalho CN, Carvalho AA, Leão JC, Gueiros LA. Congenital labial mucocele: rare presentation of a common disease. Gen Dent. 2016 Mar-Apr. 64 (2):65-7. [Medline].
Nico MM, Park JH, Lourenco SV. Mucocele in pediatric patients: analysis of 36 children. Pediatr Dermatol. 2008 May-Jun. 25(3):308-11. [Medline].
Nicolatou-Galitis O, Kitra V, Van Vliet-Constantinidou C, et al. The oral manifestations of chronic graft-versus-host disease (cGVHD) in paediatric allogeneic bone marrow transplant recipients. J Oral Pathol Med. 2001 Mar. 30(3):148-53. [Medline].
Arendorf TM, van Wyk CW. The association between perioral injury and mucoceles. Int J Oral Surg. 1981 Oct. 10(5):328-32. [Medline].
Bhaskar SN, Bolden TE, Weinmann JP. Experimental obstructive adenitis in the mouse. J Dent Res. 1956 Dec. 35(6):852-62. [Medline].
Harrison JD, Garrett JR. Mucocele formation in cats by glandular duct ligation. Arch Oral Biol. 1972 Oct. 17(10):1403-14. [Medline].
Standish SM, Shafer WG. Serial histologic effects of rat submaxillary and sublingual salivary gland duct and blood vessel ligation. J Dent Res. 1957 Dec. 36(6):866-79. [Medline].
Lattanand A, Johnson WC, Graham JH. Mucous cyst (mucocele). A clinicopathologic and histochemical study. Arch Dermatol. 1970 Jun. 101(6):673-8. [Medline].
de Brito Monteiro BV, Bezerra TM, da Silveira ÉJ, Nonaka CF, da Costa Miguel MC. Histopathological review of 667 cases of oral mucoceles with emphasis on uncommon histopathological variations. Ann Diagn Pathol. 2016 Apr. 21:44-6. [Medline].
Luiz AC, Hiraki KR, Lemos CA Jr, Hirota SK, Migliari DA. Treatment of painful and recurrent oral mucoceles with a high-potency topical corticosteroid: a case report. J Oral Maxillofac Surg. 2008 Aug. 66(8):1737-9. [Medline].
Ishida CE, Ramos-e-Silva M. Cryosurgery in oral lesions. Int J Dermatol. 1998 Apr. 37(4):283-5. [Medline].
Toida M, Ishimaru JI, Hobo N. A simple cryosurgical method for treatment of oral mucous cysts. Int J Oral Maxillofac Surg. 1993 Dec. 22(6):353-5. [Medline].
Neumann RA, Knobler RM. Treatment of oral mucous cysts with an argon laser. Arch Dermatol. 1990 Jun. 126(6):829-30. [Medline].
Yague-Garcia J, Espana-Tost AJ, Berini-Aytes L, Gay-Escoda C. Treatment of oral mucocele-scalpel versus CO2 laser. Med Oral Patol Oral Cir Bucal. 2009 Sep 1. 14(9):e469-74. [Medline].
Frame JW. Removal of oral soft tissue pathology with the CO2 laser. J Oral Maxillofac Surg. 1985 Nov. 43(11):850-5. [Medline].
Huang IY, Chen CM, Kao YH, Worthington P. Treatment of mucocele of the lower lip with carbon dioxide laser. J Oral Maxillofac Surg. 2007 May. 65(5):855-8. [Medline].
Kopp WK, St-Hilaire H. Mucosal preservation in the treatment of mucocele with CO2 laser. J Oral Maxillofac Surg. 2004 Dec. 62(12):1559-61. [Medline].
Boj JR, Poirier C, Espasa E, Hernandez M, Espanya A. Lower lip mucocele treated with an erbium laser. Pediatr Dent. 2009 May-Jun. 31(3):249-52. [Medline].
Agarwal G, Mehra A, Agarwal A. Laser vaporization of extravasation type of mucocele of the lower lip with 940-nm diode laser. Indian J Dent Res. 2013 Mar-Apr. 24(2):278. [Medline].
Zhang M, Hayashi H, Fukuyama H, Nakamura T, Kurokawa H, Takahashi T. Traumatic neuroma in the lower lip arising following laser/cryosurgery to treat a mucocele. Oral Dis. 2003 May. 9(3):160-1. [Medline].