Neoplasia Mucinosa de apéndice. Abordaje laparoscópico. Reporte de caso / Neoplastic appendiceal mucinous lesion. Laparoscopic approach. Case report

El mucocele apendicular es la dilatación quística del apéndice con acumulación de material mucinoso. Su forma de presentación más frecuente es dolor en fosa ilíaca derecha, sin embargo, la mitad de los casos son asintomáticos. En el presente trabajo se presenta caso de un paciente con diagnóstico incidental de mucocele apendicular, al cual se le realizó apendicectomía laparoscópica como tratamiento definitivo. Caso clínico: Paciente masculino de 44 años sin antecedentes patológicos conocidos, quien se realiza ultrasonido abdominal que informa tumor quístico en fosa ilíaca derecha. Se decide resolución quirúrgica laparoscópica. Informe histológico: mucocele apendicular sin evidencia de malignidad y recuperación satisfactoria del paciente. Conclusión: La neoplasia mucinosa del apéndice es una patología poco frecuente, puede presentarse con una variedad de manifestaciones clínicas hasta un hallazgo incidental. El tratamiento es fundamentalmente quirúrgico y el abordaje laparoscópico es de elección en pacientes sin evidencia de ruptura y diseminación de la enfermedad(AU)

The appendicular mucocele is a cystic dilation of the appendix with accumulation of mucinous material. The most frequent form of presentation is pain in the right iliac fossa; however, half of the cases are asymptomatic patients. In the present work we present a case of a patient with an incidentally diagnosis of appendicular mucocele who underwent laparoscopic appendectomy as definitive treatment. Clinical case: A 44-year-old male patient with no known pathological history, who underwent an abdominal ultrasound that reported a cystic tumor in the right iliac fossa. Laparoscopic surgical resolution was decided, the histological examination revealed appendicular mucocele without evidence of malignancy and satisfactory recovery of the patient. Conclusion: Mucinous neoplasia of the appendix is an uncommon pathology, patients are often asymptomatic or have nonspecific symptoms, and the diagnosis is made incidentally in the course of other examination. Treatment is primarily surgical and the laparoscopic approach is the choice in patients without evidence of rupture and dissemination of the disease(AU)

A multicenter study of biopsied oral and maxillofacial lesions in a Brazilian pediatric population

Abstract The aim of this study was to investigate the prevalence of oral and maxillofacial lesions among children from representative regions of Brazil. A retrospective descriptive study was conducted. Biopsy records comprising the period from 2000 to 2015 were obtained from the archives of three Brazilian oral pathology referral centers. A total of 32,506 biopsy specimens were analyzed, and specimens from 1,706 children aged 0-12 years were selected. Gender, age, anatomical location and histopathological diagnosis were evaluated. Descriptive statistics was carried out. Likelihood ratio tests were used to evaluate the association between the categorical variables. The level of significance was set at 0.05. The post-hoc test was used to identify the subgroups that significantly differed from one another, and the Bonferroni correction was applied. A total of 1,706 oral and maxillofacial lesions were diagnosed in pediatric patients, including 51.9% girls. Oral mucocele was the most prevalent reactive/inflammatory lesion (64%). The most commonly affected sites were the lips (34.5%) and mandible (19.9%). A significant association was observed between age and the group of lesions of the oral cavity (p < 0.001), and between age and anatomical location (p < 0.001). Pediatric oral and maxillofacial lesions were frequent and showed wide diversity, with the prevalence of mucocele. Knowledge of oral lesions is important for pediatric dentists worldwide, since it provides accurate data for the diagnosis and oral health of children.

Oral Nodular Lesions in Patients with Sjögren's Syndrome: Unusual Oral Implications of a Systemic Disorder

Abstract Sjögren's syndrome (SS) is a systemic chronic autoimmune disorder affecting the lacrimal and salivary glands. SS may manifest as primary SS (pSS) or secondary SS (sSS), the latter occurring in the context of another autoimmune disorder. In both cases, the dry eyes and mouth affect the patient's quality of life. Late complications may include blindness, dental tissue destruction, oral candidiasis and lymphoma. This paper reports two cases of SS, each of them presenting unusual oral nodular lesion diagnosed as relapsed MALT lymphoma and mucocele. The importance of the diagnosis, treatment and management of the oral lesions by a dentist during the care of SS patients is emphasized, as the oral manifestations of SS may compromise the patient's quality of life.

Resumo A síndrome de Sjögren (SS) é uma doença autoimune crônica sistêmica que afeta as glândulas lacrimal e salivar. A SS pode se manifestar como SS primária (SSp) ou SS secundária (SSs), a última ocorrendo em conjunto com outra desordem autoimune. Em ambos os casos, os olhos secos e a boca seca afetam a qualidade de vida do paciente. As complicações tardias podem incluir cegueira, destruição dos tecidos dentários, candidíase oral e linfoma. Este artigo relata dois casos de SS, cada um apresentando lesão nodular oral incomum diagnosticada como linfoma MALT reincidente e mucocele. A importância do diagnóstico, tratamento e manejo das lesões orais por um cirurgião-dentista durante o atendimento de pacientes com SS é enfatizada, pois as manifestações orais da SS podem comprometer a qualidade de vida do paciente.

Mucocele and Fibroma: Treatment and Clinical Features for Differential Diagnosis

Mucocele is a benign lesion occurring in the buccal mucosa as a result of the rupture of a salivary gland duct and consequent outpouring of mucin into soft tissue. It is usually caused by a local trauma, although in many cases the etiology is uncertain. Mucocele is more commonly found in children and young adults, and the most frequent site is the lower inner portion of the lips. Fibroma, on the other hand, is a benign tumor of fibrous connective tissue that can be considered a reactionary connective tissue hyperplasia in response to trauma and irritation. They usually present hard consistency, are nodular and asymptomatic, with a similar color to the mucosa, sessile base, smooth surface, located in the buccal mucosa along the line of occlusion, tongue and lip mucosa. Conventional treatment for both lesions is conservative surgical excision. Recurrence rate is low for fibroma and high for oral mucoceles. This report presents a series of cases of mucocele and fibroma treated by surgical excision or enucleation and the respective follow-up routine in the dental clinic and discusses the features to be considered in order to distinguish these lesions from each other.

Mucocele é uma lesão comum na mucosa bucal, que resulta da ruptura de um ducto de glândula salivar e consequente derramamento de mucina para o interior dos tecidos moles circunjacentes. Frequentemente este derrame resulta de trauma local, embora em muitos casos a etiologia seja indefinida. É uma lesão não infecciosa benigna, que frequentemente afeta a cavidade bucal de crianças e adultos jovens, localizando-se geralmente na porção interna dos lábios inferiores. Por outro lado, o fibroma é um tipo de tumor benigno do tecido conjuntivo fibroso que pode ser considerado uma hiperplasia reacional do tecido conjuntivo em resposta a traumas e irritação. Geralmente são nodulares, com consistência firme, assintomáticos, coloração semelhante à da mucosa, base séssil, superfície lisa, localizados na mucosa jugal ao longo da linha de oclusão, língua e mucosa labial. O tratamento convencional para ambas as lesões é a excisão cirúrgica conservadora, sendo que sua recorrência é rara para fibromas e alta para as mucoceles. Este trabalho relata casos clínicos de mucocele e fibroma, tratados pela técnica de excisão cirúrgica ou enucleação, bem como descreve a proservação no consultório odontológico. As características importantes para o diagnóstico diferencial dessas lesões são discutidas.

Mucocele apendicular gigante: reporte de un caso y revisión de la literatura / Giant appendiceal mucocele: case report and review of the literature

El mucocele apendicular (MA) corresponde a una dilatación quística del lumen apendicular rellena por mucus en su interior; secundario a etiologías de naturaleza benigna (hiperplasia mucinosa y cistoadenoma) o maligna (cistoadenocarcinoma).Se trata de una condición infrecuente, reportándose en no más allá del 0,3 por ciento de las apendicectomías. Su tamaño y manifestaciones clínicas son extremadamente variables, permitiendo el estudio anatomo-patológico de la pieza quirúrgica establecer el diagnóstico etiológico. Presentamos el caso de un MA gigante secundario a un cistoadenoma mucinoso, diagnosticado en un hombre de 57 años en la Unidad de Anatomía Patológica del Hospital Hernán Henríquez Aravena de Temuco...

Appendiceal mucocele (AM) is a cystic dilatation of the appendiceal lumen filled by mucus inside, secondary to benign etiologies (hyperplasia and mucinous cystadenoma) or malignant (cystadenocarcinoma). This condition is uncommon, being reported in no more than 0.3 percent of appendectomies. Its size and clinical manifestations are extremely variable, allowing the pathological analysis of the surgical specimen etiologic diagnosis. We report a case of a giant AM secondary to a mucinous cystadenoma diagnosed in a 57-year-old man in the Pathology Unit of Hospital Hernán Henríquez Aravena of Temuco...

Mucocele de las glándulas Blandin-Nuhn, aspectos patológicos y terapéuticos, a propósito de dos casos clínicos / Mucocele of the glands of Blandin-Nuhn

Las glándulas de Blandin-Nuhn son un grupo de pequeñas glándulas salivales mucoserosas, ubicadas en el espesor de los haces musculares de la zona anterior de la cara ventral de la lengua. Los mucoceles de las glándulas de Blandin-Nuhn son poco frecuentes. Se revisa la literatura y se presentan dos casos de mucocele de las glándulas de Blandin-Nuhn, ambos casos eran lesiones exofíticas, indoloras, una de ellas asociada a trauma. Los mucoceles de las glándulas salivales linguales anteriores deben ser resecados hasta el plano muscular para evitar la recidiva. Como esta lesión puede ser confundida con otras patologías, se recomienda su estudio histopatológico para evitar diagnósticos errados.

The Blandin-Nuhn glands are a small group of mucous serous salivary glands, located in the thickness of the muscle bundles of the anterior ventral side of the tongue. Mucocele of the glands of Blandin-Nuhn has been reported as unusual. We review the literature and present two cases of mucocele of the glands of Blandin-Nuhn, both cases were exophytic lesions, painless, one associated with trauma. Mucoceles of the salivary glands should be resected up to the muscular plane to avoid recurrence. Because this lesion may be confused with other diseases, it is recommended an histopathological exam to avoid misdiagnosis.

Diagnóstico: tratamento cirúrgico e proservação de um caso clínico de mucocele / Diagnosis, surgical treatment and proactive observation of a case of mucacele

O mucocele é uma lesão comum da mucosa bucal, que resulta da ruptura de um ducto deotglândula salivar e consequente derramamento de mucina para o interior dos tecidos moles circunjacentes. Pode surgir em vários sítios da cavidade bucal sendo o lábio inferior região mais prevalente, contabilizando mais de 80% dos casos. Como forma de tratamento, pode ser realizada a exérese local, com a enucleação e remoção da glândula salivar, e ou tratada por eletrocirurgia, criocirurgia ou pela vaporização com laser de C02. O objetivo deste trabalho é apresentar uma revisão de literatura a respeito do mucocele, bem como um relato de caso clinico e a opção de tratamento escolhida.

The mucocele is a common injury of the oral mucosa, resulting from a ruptured salivarygland duct and consequent spillage of mucin into the interior of the surrounding soft tissues. Can arise in various sites of the oral cavity and the lower lip area was the most prevalent, accounting for more than 80% of cases. As a form of treatment can be performed local excision with enucleation and remova I of the salivary gland, and I or treated by electrosurgery, cryosurgery or laser vaporization of C02. The aim of this paper is to present a review of the literature regarding the mucocele and one case report and treatment option chosen.

Tratamento do fenômeno de extravasamento/retenção de muco pela técnica de micro-marsupialização modificada associado ou não ao uso do laser de baixa intensidade: ensaio clíncio controlado e randomizado

Avaliar o efeito do laser de baixa intensidade (LBI) em reduzir recorrências e aliviar a dor tratamento do fenômeno de extravasamento/retenção de muco pela técnica de micro-marsupialização modificada. Materiais e método: seis pacientes com rântulas orais e mucoceles selecionadas foram submetidos ao tratamento de micro-marsupialização (grupo controle) e onze pacientes foram submetidos ao tratamento de micro-marsupialização associado ao LBI (grupo laser). Os pacientes do grupo laser foram irradiados utilizando um laser de Arseanato de Gálio-Alumínio (AsGaAl) em um comprimento de onda de 660 nm em modo contínuo, com uma potência de 100 mW...

Mucocele en glándulas de Blandin-Nuhn o glándulas linguales anteriores: reporte de un caso / Mucocele in glands of Blandin-Nuhn or previous lingual glands: a case report

El mucocele es un quiste que consiste en una colección de mucina proveniente de la ruptura del conducto de una glándula salival, por lo general asociado a trauma local. Se describe un caso de un paciente masculino de 22 años de edad, natural y procedente de Caracas que acude a consulta por presentar lesión en la cara ventral de la lengua desde hace aproximadamente 3 meses que le imposibilita comer y hablar. Al examen clínico intrabucal, se presenta una lesión de 2x2 cm de extensión, del mismo color de la mucosa, dolorosa a la palpación, la cual imposibilita la movilidad de la lengua. El tratamiento consistió en la marsupialización de la lesión

The mucocele is a cyst that consists of a collection of mucin from the break of the conduct of a salivary gland, generally associated with local trauma. There is described a case of a 22-year-old male patient , natural from Caracas who comes for presenting injury in the ventral surface of the tongue from approximately 3 months that disables him to eat and to speak. To the clinical examination, appears an injury of 2x2 cm of extension, of the same color of mucous, painful to the palpation, which disables the mobility of the tongue. The treatment consisted of the marsupialization of the injury

Morphology of collagen fibers and elastic system fibers in actinic cheilitis.

Background: Actinic cheilitis (AC) is a premalignant condition intimately related to exposure of the lips to sun rays. Aim: The objective of this study was to evaluate the elastic and collagen fibers in the lamina propria of AC. The degree of epithelial atypia was correlated with the quantity of elastic and collagen fibers. Materials and Methods: Fifty-one cases were investigated. One slide was stained with hematoxylin-eosin for the evaluation of atypia, the second was stained with Weigert's resorcin-fuchsin for the assessment of elastic fibers, and the third slide was stained with Mallory's trichrome for the analysis of collagen fibers. Results: Ordinal logistic regression analysis revealed a significant correlation between the presence of atypia and collagen fibers (P<0.05). Conclusions: It was concluded that there seems to be a reduction in the quantity of collagen fibers in cases of moderate and severe atypia. No correlation was observed between the degradation of elastic system fibers and the grade of dysplasia.

Comparison of Clinical Characteristics between Primary and Secondary Paranasal Mucoceles

PURPOSE: Paranasal sinus mucocele is a benign, expansile mass which can occur as a result of trauma or spontaneous obstruction of a sinus tract. The purpose of this study was to describe and compare the clinical characteristics of primary mucoceles occurring in patients with no previous sinus surgery history or known cause of mucoceles and secondary mucoceles resulting as a complication following endoscopic sinus surgery or the Caldwell-Luc operation. MATERIALS AND METHODS: We performed a retrospective chart review of 33 cases of primary mucoceles and 60 cases of secondary mucoceles which were diagnosed and surgically corrected between 1996 and 2008. RESULTS: The most common presenting symptoms in primary mucoceles were nasal obstruction (19.4%) and rhinorrhea (17.7%). In secondary mucoceles, the most common symptoms were cheek pain (31.7%) and nasal obstruction (18.3%). The most common origins of primary mucoceles were the ethmoid sinus (45.5%) and the maxillary sinus (18.2%). In secondary mucoceles, the maxillary sinus was the most common site (86%), followed by the ethmoid sinus (7.1%). All patients with secondary mucoceles had a history of sinus surgery. CONCLUSION: The maxillary sinus was the most common site of secondary mucoceles while the ethmoid sinus was the most common origin of primary mucoceles. Cases of secondary mucoceles that occurred following sinus endoscopic surgery developed more frequently in the ethmoid sinus than in those following the Caldwell-Luc procedure, therefore, we suggest that the incidence of maxillary sinus mucoceles in the Asian population would decrease as the rate of endoscopic sinus surgery increases.

Mucocele etmoidal e frontoetmoidal com extensão orbitária: relato de dois casos / Ethoid and front-ethmoid mucocele with orbit extension: report of two cases

As mucoceles dos seios paranasais são lesões císticas de revestimento epitelial com conteúdo mucóide, que apresentam crescimento lento com características expansivas e de reabsorção óssea. Eventualmente, podem comprometer as estruturas nobres adjacentes como aórbita e a cavidade intracraniana.Relato de caso - Caso 1: Paciente masculino, 55 anos, com tumoração na região medial da órbita esquerdacom evolução progressiva que iniciou há 10 meses. Apresentava restrição na elevação do olho em supraversão à direita. Exame tomográfico compatível com mucocele etmoidal. Submetido a etmoidectomia externa, apresentou boa evolução no pós-operatório e permaneceassintomático até o momento. Caso 2: Paciente masculino, 65 anos, com baixaacuidade visual progressiva no olho direito há 5 meses após aparecimento de tumoração indolor na região superiorda órbita direita que evoluía progressivamente há 1 ano. Apresentava acuidade visual de vultos e atrofia de nervo óptico no olho direito. Mobilidade ocular com restrição. Tomografia computadorizada confirmou o diagnóstico de mucocele fronto-etmoidal. Discussão: As mucoceles apresentam um crescimento lento e, por este motivo, em muitos casos, a lesãopode alcançar a órbita antes dos pacientes procurarem auxílio. A complicação mais grave das mucoceles periorbitárias é a perda da visão. Seu crescimento através da órbita pode produzir compressão do globo ocular caucausando lesões no nervo óptico e no pólo posterior. O tratamento das mucoceles é cirúrgico, sendo que as vias de acesso podem ser externa e endonasal.

Paranasal sinus mucoceles are cystic lesions with an epithelial revestment containing mucus, that grow slowlywith expansive characteristics, reabsorbing surrounding bones. Eventually, they can compromise important structures as the orbit and the intracranial cavity. Case report - Case 1: A 55 year-old male came to our clinic complaining of a tumor in nasal left orbit with slow progression for 10 months. Physical examination revealed supraversion of left eye. Computed tomography (CT) imaging showed ethmoid sinus mucocele. The patient underwent external ethmoidectomy with good evolution and remains asymptomatic until now. Case 2: A 65 year-old male, with progressive righteye low vision for 5 months after the appearing of a painless tumor at the superior region of the right orbit thatwas slowly growing for 1 year. Visual acuity of shadows and optic nerve atrophy in the right eye. General limitedeye movement of the right eye. CT confirmed frontal and ethmoid mucocele.Discussion: Mucoceles have slow progression and, for this reason, in many cases, they can reach the orbitbefore patient look for help. The most severe complication of the periorbital mucoceles is blindness. While theygrow inside the orbit, they can compress the eyeball and injure the posterior pole and the optic nerve. The treatmentis based on surgery, that can be performed by external or endonasal access.

Lesiones mucocele-like de la mama: experiencia local y revisión de la literatura / Mucocele-like lesions of the breast: local experience and review of the literature

Mucocele-like lesions of the breast are uncommon. They where first described by Rosen in 1986. Pathologically, they are defined as mucin filled cysts and extravasated mucin in the adjacent stroma, without inflammatory reaction. We present eight cases of mucocele-like lesions in six patients, emphasizing the clinical and radiological findings and features of the respective percutaneous and excisional biopsies. Considering their frequent association with high risk type lesions (4/8 = 50%) and also with ductal carcinomas in situ or mucinous carcinomas (1/7 = 14%), surgical excision is recommended to exclude malignancy.

La lesión mucocele-like (LML) es infrecuente, fue descrita por primera vez por Rosen en 1986; se define anatomopatológicamente como área de quistes conteniendo mucina, con presencia de mucina extravasada en el estroma adyacente debido a la rotura de quistes, sin reacción inflamatoria asociada. Se presentan ocho casos de LML diagnosticados en seis pacientes, haciendo énfasis en las características clínicas, imaginológicas y hallazgos de las respectivas biopsias percutáneas y excisionales. Considerando su frecuente asociación con lesiones de alto riesgo, (4/8=50%) y también con cáncer in situ o cáncer infiltrante mucinoso (1/7=14%), la recomendación actual es la biopsia quirúrgica para excluir malignidad.

Laparoscopic appendectomy for mucocele of the appendix: Report of 8 cases.

Mucocele of the appendix is an aseptic dilatation secondary to obstruction. Surgical excision is the treatment of choice in benign mucocele. The incidence of mucocele of the appendix in our center is 0.15%, of a total of 6000 appendectomies over 8 years. We operated on 9 cases; laparoscopic appendectomy was done in 8 of them. One patient had pseudomyxoma peritonei, so open surgery was done. Other organs were also examined as there is a possibility of concurrent tumors. As there is risk of malignancy of the appendix leading to port-site metastasis we used a non-permeable bag to remove the resected specimen.

Histopathology and ultrastructural features in mucous extravasation phenomenon: report of a case

Histopathological and ultrastructural features of a case of pseudocyst extravastation mucocele lesion located in the lower lip of an 18 yearold Malaysian female is presented. Complete surgical excision of the lesion with associated minor salivary glands was done. The specimenwas processed for routine histopathology and transmission electron microscopy (TEM) for ultrastructral studies. The lesion revealed pooling of mucin infiltrated with inflammatory cells and walled by a rim of granulation tissue. The underlying salivary lobules showed varying degrees of chronic sclerosing sialadenitis. Ultrastructural features revealed multiple membrane bound electron lucent mucus granules with varying diameter, duct cells with few microvilli. Desmosomes, tonofilaments and myoepithelial cells were prominent. There were also dilatation of the rough endoplasmic reticulum (RER)and presence of multiple electron dense granules

Histopathology and ultrastructural features in mucous extravasation phenomenon: report of a case%Aspectos histopatológicos e estruturais no fenômeno de extravasamento da mucosa: um estudo de caso

Histopathological and ultrastructural features of a case of pseudocyst extravastation mucocele lesion located in the lower lip of an 18 yearold Malaysian female is presented. Complete surgical excision of the lesion with associated minor salivary glands was done. The specimenwas processed for routine histopathology and transmission electron microscopy (TEM) for ultrastructral studies. The lesion revealed pooling of mucin infiltrated with inflammatory cells and walled by a rim of granulation tissue. The underlying salivary lobules showed varying degrees of chronic sclerosing sialadenitis. Ultrastructural features revealed multiple membrane bound electron lucent mucus granules with varying diameter, duct cells with few microvilli. Desmosomes, tonofilaments and myoepithelial cells were prominent. There were also dilatation of the rough endoplasmic reticulum (RER)and presence of multiple electron dense granules