Dermatologic Manifestations of Mucous Cyst Treatment & Management

  • Author: Christopher R Shea, MD; Chief Editor: William D James, MD   more...
 
Updated: Jan 12, 2012
 

Medical Care

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.[15]

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Surgical Care

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.[16, 17] 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.[18] 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.[19] 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.[20, 21, 22] 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.[21]
  • Erbium laser treatment has also been described in a pediatric patient, with excellent results.[23]
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Consultations

  • Dermatologist
  • Dermatologic surgeon
  • Oral medicine specialist
  • Oral surgeon
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Contributor Information and Disclosures
Author

Christopher R Shea, MD  Professor and Chief, Section of Dermatology, Department of Medicine, University of Chicago, The Pritzker School of Medicine

Christopher R Shea, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society of Dermatopathology, Arthur Purdy Stout Society, Association of Professors of Dermatology, Chicago Dermatological Society, Dermatology Foundation, Illinois Dermatological Society, International Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Markus D Boos, MD, PhD  Resident, University of Chicago Comer Children's Hospital

Markus D Boos, MD, PhD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Pediatrics

Disclosure: Nothing to disclose.

Specialty Editor Board

David P Fivenson, MD  Associate Director, St Joseph Mercy Hospital Dermatology Program, Ann Arbor, Michigan

David P Fivenson, MD is a member of the following medical societies: American Academy of Dermatology, Medical Dermatology Society, Michigan Dermatological Society, Michigan State Medical Society, Photomedicine Society, Society for Investigative Dermatology, and Wound Healing Society

Disclosure: Nothing to disclose.

Richard P Vinson, MD  Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Warren R Heymann, MD  Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous author, M. Angelica Selim, MD, to the development and writing of this article.

References

  1. Oliveira DT, Consolaro A, Freitas FJ. Histopathological spectrum of 112 cases of mucocele. Braz Dent J. 1993;4(1):29-36. [Medline].

  2. Chaudhry AP, Reynolds DH, Lachapelle CF, Vickers RA. A clinical and experimental study of mucocele (retention cyst). J Dent Res. Nov-Dec 1960;39:1253-62. [Medline].

  3. 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].

  4. 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. Sep 2011;42(8):679-85. [Medline].

  5. 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. Apr 2011;69(4):1086-93. [Medline].

  6. Bouquot JE, Gundlach KK. Oral exophytic lesions in 23,616 white Americans over 35 years of age. Oral Surg Oral Med Oral Pathol. Sep 1986;62(3):284-91. [Medline].

  7. Yamasoba T, Tayama N, Syoji M, Fukuta M. Clinicostatistical study of lower lip mucoceles. Head Neck. Jul-Aug 1990;12(4):316-20. [Medline].

  8. Nico MM, Park JH, Lourenco SV. Mucocele in pediatric patients: analysis of 36 children. Pediatr Dermatol. May-Jun 2008;25(3):308-11. [Medline].

  9. 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. Mar 2001;30(3):148-53. [Medline].

  10. Arendorf TM, van Wyk CW. The association between perioral injury and mucoceles. Int J Oral Surg. Oct 1981;10(5):328-32. [Medline].

  11. Bhaskar SN, Bolden TE, Weinmann JP. Experimental obstructive adenitis in the mouse. J Dent Res. Dec 1956;35(6):852-62. [Medline].

  12. Harrison JD, Garrett JR. Mucocele formation in cats by glandular duct ligation. Arch Oral Biol. Oct 1972;17(10):1403-14. [Medline].

  13. Standish SM, Shafer WG. Serial histologic effects of rat submaxillary and sublingual salivary gland duct and blood vessel ligation. J Dent Res. Dec 1957;36(6):866-79. [Medline].

  14. Lattanand A, Johnson WC, Graham JH. Mucous cyst (mucocele). A clinicopathologic and histochemical study. Arch Dermatol. Jun 1970;101(6):673-8. [Medline].

  15. 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. Aug 2008;66(8):1737-9. [Medline].

  16. Ishida CE, Ramos-e-Silva M. Cryosurgery in oral lesions. Int J Dermatol. Apr 1998;37(4):283-5. [Medline].

  17. Toida M, Ishimaru JI, Hobo N. A simple cryosurgical method for treatment of oral mucous cysts. Int J Oral Maxillofac Surg. Dec 1993;22(6):353-5. [Medline].

  18. Neumann RA, Knobler RM. Treatment of oral mucous cysts with an argon laser. Arch Dermatol. Jun 1990;126(6):829-30. [Medline].

  19. 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. Sep 1 2009;14(9):e469-74. [Medline].

  20. Frame JW. Removal of oral soft tissue pathology with the CO2 laser. J Oral Maxillofac Surg. Nov 1985;43(11):850-5. [Medline].

  21. Huang IY, Chen CM, Kao YH, Worthington P. Treatment of mucocele of the lower lip with carbon dioxide laser. J Oral Maxillofac Surg. May 2007;65(5):855-8. [Medline].

  22. Kopp WK, St-Hilaire H. Mucosal preservation in the treatment of mucocele with CO2 laser. J Oral Maxillofac Surg. Dec 2004;62(12):1559-61. [Medline].

  23. Boj JR, Poirier C, Espasa E, Hernandez M, Espanya A. Lower lip mucocele treated with an erbium laser. Pediatr Dent. May-Jun 2009;31(3):249-52. [Medline].

  24. 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. May 2003;9(3):160-1. [Medline].

  25. Bhaskar SN, Bolden TE, Weinmann JP. Pathogenesis of mucoceles. J Dent Res. Dec 1956;35(6):863-74. [Medline].

  26. Cataldo E, Mosadomi A. Mucoceles of the oral mucous membrane. Arch Otolaryngol. Apr 1970;91(4):360-5. [Medline].

  27. Cohen L. Mucoceles of the oral cavity. Oral Surg Oral Med Oral Pathol. Mar 1965;19:365-72. [Medline].

  28. Correll RW, Friedlander AH. Painless swelling of the lower lip. J Am Dent Assoc. Nov 1988;117(6):761-2. [Medline].

  29. Crean SJ, Connor C. Congenital mucoceles: report of two cases. Int J Paediatr Dent. Dec 1996;6(4):271-5. [Medline].

  30. Davis SB, Simon JH. Mucocele: a potential complication to endodontic surgery. J Endod. Oct 1994;20(10):515-7. [Medline].

  31. Dent CD, Svirsky JA, Kenny KF. Large mucous retention phenomenon (mucocele) of the upper lip. Case report and review of the literature. Va Dent J. Jan-Mar 1997;74(1):8-9. [Medline].

  32. Eveson JW. Superficial mucoceles: pitfall in clinical and microscopic diagnosis. Oral Surg Oral Med Oral Pathol. Sep 1988;66(3):318-22. [Medline].

  33. Galloway RH, Gross PD, Thompson SH, Patterson AL. Pathogenesis and treatment of ranula: report of three cases. J Oral Maxillofac Surg. Mar 1989;47(3):299-302. [Medline].

  34. Harrison JD. Salivary mucoceles. Oral Surg Oral Med Oral Pathol. Feb 1975;39(2):268-78. [Medline].

  35. Jensen JL. Superficial mucoceles of the oral mucosa. Am J Dermatopathol. Feb 1990;12(1):88-92. [Medline].

  36. Mandel L. Ranula, or, what's in a name?. N Y State Dent J. Jan 1996;62(1):37-9. [Medline].

  37. Morton RP, Bartley JR. Simple sublingual ranulas: pathogenesis and management. J Otolaryngol. Aug 1995;24(4):253-4. [Medline].

  38. Robinson L, Hjorting-Hansen E. Pathologic changes associated with mucus retention cysts of minor salivary glands. Oral Surg Oral Med Oral Pathol. Aug 1964;18:191-205. [Medline].

  39. Sela J, Ulmansky M. Mucous retention cyst of salivary glands. J Oral Surg. Aug 1969;27(8):619-23. [Medline].

  40. Standish SM, Shafer WG. The mucus retention phenomenon. J Oral Surg Anesth Hosp Dent Serv. Jul 1959;17(4):15-22. [Medline].

  41. Weir TW, Johnson WC. Cheilitis glandularis. Arch Dermatol. Apr 1971;103(4):433-7. [Medline].

  42. Wilcox JW, History JE. Nonsurgical resolution of mucoceles. J Oral Surg. Jun 1978;36(6):478. [Medline].

  43. Yoshikawa F, Okunishi Y, Sakuda M. Mucous cyst forming on the dorsal surface of the tongue: report of a case. J Oral Maxillofac Surg. Jul 1994;52(7):770-1; discussion 772. [Medline].

 
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The submucosa shows a mucin-filled, cystlike cavity below the squamous mucosa. Minor salivary gland lobules are present in the submucosa.
The wall of the lesion is usually formed by connective tissue, inflammatory cells, foamy macrophages (lower left corner), and salivary gland acini (upper right corner).
 
 
 
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