Utilidad del parche cutáneo de hioscina en el tratamiento del sialocele persistente posparotidectomía: observación clínica / Utility of transdermal hyoscine in the treatment of persistent postparotidectomy sialocele: a case report

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Frontal sinus mucocoeles: new algorithm for surgical management.

BACKGROUND: Frontal sinus mucocoeles require a structured approach to their surgical management. We share our experience of a novel method of positional classification for frontal mucocoele and corresponding surgical algorithm. METHODS: A retrospective case-note review examined all frontal sinus surgery for mucocoele, spanning three years (2008-2010). Patients had pre-operative nasendoscopy, multi-planar CT and MRI when indicated. Several important variables (position, drainage dimensions, fronto-ethmoidal cells and degree of neo-osteogenesis) were noted. A systematic algorithm was used for surgical drainage based on these characteristics. The three year outcomes using this approach are presented. RESULTS: Thirty-six patients were identified with a total of 43 frontal mucocoeles. Using our classification, 30 mucocoeles were medial; seven were intermediate; six were lateral. Thirty-four patients underwent a primary endoscopic procedure; six required a combined primary osteoplastic-flap (OPF) and endoscopic approach. Six patients required revision surgery for polypoidal change or neo-ostium stenosis. All patients were eventually rendered asymptomatic. CONCLUSION: Implementation of our positional classification and surgical algorithm was successful with a revision rate of 19%. Presence of frontal sinus wall dehiscence and extra-sinus mucocoele extension are invalid indicators for external approach. We feel our classification and treatment algorithm, with its associated indicators for surgical escalation (i.e. limited dimensions of frontal ostium, presence of Type III / IV front-ethmoidal cells etc), are applicable for future management of frontal mucocoeles.

Salivary gland diseases: infections, sialolithiasis and mucoceles.

The three most frequently diagnosed salivary gland diseases are salivary gland infections, sialolithiasis and mucoceles. Salivary gland infections are usually of bacterial or viral etiology and can be divided into acute and chronic types. Occasionally they can result from obstruction of the salivary duct, an autoimmmune disease or cancer therapy. Infections can occur in all types of salivary glands and are observed at all ages. Sialolithiasis is characterized by the development of calcified structures in the salivary glands, especially in the submandibular gland. Sialoliths are generally attributed to retention of saliva and are usually accompanied by swelling and pain when a salivary stimulus is applied. Mucoceles can be differentiated into mucus extravasation phenomenon or mucus escape reaction, mucus retention cysts and ranulas. They result from extravasation of saliva into the surrounding soft tissues or from retention of saliva within the duct.

Mucocele--a study of 36 cases.

BACKGROUND: Mucocele is one of the most common benign soft tissue tumor present in the oral cavity. They are of two types - one is extravasation and second one is retention type but the majority are extravasation type. AIMS: The objective is to determine various factors related to mucocele such as role of trauma due to nearby teeth, recurrence, duration, and to find out whether there is any role of psychological stress which initiates trauma like lip or cheek biting. MATERIALS AND METHODS: 36 cases of mucocele diagnosed at the Department of the Oral Pathology, Govt. Dental College and Hospital, Ahmedabad, between 2004 and 2008 were reviewed. The clinical data were recorded and histopathologic diagnosis was made. STATISTICAL ANALYSIS USED: Data analysis tool, Microsoft Office Excel 2007. RESULTS: A diagnosis of mucocele was established in 36 cases with male-to-female ratio of 1.77:1. Most common type was extravasation in 30 (83.33%) cases. The peak age of occurrence was between 1st and 3rd decade. Lateral side of the lower labial mucosa was the most affected site in 34 (94.44%) cases. The history of trauma appeared the major etiological factor seen in 28 (77.77%) cases. CONCLUSION: We conclude that there was male predominance and they were more affected in 2nd and 3rd decade. The lateral side of lower labial mucosa was the commonest site and the trauma due to teeth or lip biting was the major etiological factor for the occurrence of the mucocele. The article highlights role of psychological stress in occurrence of mucocele. The reader should understand the importance of histopathology examination and should try to control the psychological stress in such mucocele patients.

Mucocele apendicular / No disponible

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Mucocele apendicular: reporte de un caso clínico / Appendicular mucocele: report of a clinical case

La patología tumoral de apéndice presenta baja incidencia. Dentro de este grupo el mucocele alcanza al 0,2 a 0,4 por ciento de todas las apendicectomías. El término mucocele describe una dilatación quística del lumen apendicular por mucus, que incluye diferentes entidades anatomopatológicas. El caso clínico es una paciente de sexo femenino de 73 años, con una cuadro de 2 meses de dolor abdominal localizado en hemiabdomen inferior, de intensidad moderada, asociado a dificultad para la micción, baja de peso de 8 kilos y compromiso del estado general. Al examen físico se constata una masa en fosa ilíaca derecha de aproximadamente 10 cm de diámetro mayor. Se realizó un TAC de abdomen y pelvis que mostró masa tubular de 10 x 5 cm de diámetros con material hipodenso en su interior, compatible con mucocele apendicular. Se realizó en el Hospital Clínico de la Universidad de Chile una laparotomía exploradora confirmando los hallazgos del TAC, se realizó apendicectomía y el estudio de la pieza informó cistoadenoma mucinoso del apéndice con displasia leve. Los posibles hallazgos histopatológicos de los mucoceles incluyen hiperplasia mucosa, cistoadenoma como en este caso y cistoadenocarcinoma, que es la variante neoplásica maligna. En correspondencia a la histopatología de este caso se recomienda la apendicectomía como tratamiento.

Aspiration biopsy of mammary lesions with abundant extracellular mucinous material. Review of 43 cases with surgical follow-up.

We reviewed 43 fine-needle aspiration biopsy (FNAB) smears with abundant extracellular mucinous material to determine whether accurate classification of mucinous lesions is achievable on FNAB: 26 had carcinoma (pure colloid carcinoma [CCA], 23; mixed CCA/invasive ductal carcinoma [IDC], 3); 17 had benign lesions on follow-up (benign MLL, 6; fibrocystic change [FCC], 6; myxoid fibroadenoma [MFA], 5). All carcinomas were identified correctly as malignant on FNAB. The initial cytologic diagnoses in benign cases were benign in 8, atypical in 8, and "suspicious" for carcinoma in 1. CCAs were moderate to markedly cellular with mild to moderate atypia and lacked oval bare nuclei. Marked nuclear atypia was confined predominantly to cases with mixed CCA/IDC. A distinct feature of CCA was thin-walled capillaries. FCCs and benign MLLs had overlapping cytologic features and showed variable cellularity and no or mild atypia. MFAs were markedly cellular with dyscohesion and variable atypia; stromal fragments and oval bare nuclei were present in every case. Mucinous lesions can be divided into 2 categories by FNAB: those that are adenocarcinomas and those that are not. CCAs have distinctive features that allow a definitive diagnosis on FNAB. Unnecessary surgery can be avoided in MFA by careful evaluation of smear characteristics. Cytologic features of FCC and MLL overlap. Owing to the documented association of MLL with carcinoma, we recommend that lesions that cannot be classified definitively as adenocarcinoma or MFA be considered for conservative excision, even in the absence of atypia.

Can mucinous lesions of the breast be reliably diagnosed by core needle biopsy?

Lesions of the breast containing extravasated mucin span a continuum from benign mucoceles to invasive mucinous (colloid) carcinoma. It is well known that distinguishing benign from malignant mucinous lesions is difficult infine-needle aspiration material. Whether these lesions also are difficult to distinguish in core needle biopsy material is not known. To address this, I reviewed the results of 4,297 breast core needle biopsies. Mucinous lesions were identified in 22 cases (0.51%), and excisional biopsy material was available for 15 of these. At excision, 0 of 8 benign mucinous lesions showed carcinoma, while 7 of 7 mucinous lesions associated with carcinoma at the time of core needle biopsy showed carcinoma at excision. The vast majority of mucinous lesions of the breast can be diagnosed accurately by core needle biopsy. Whether all such lesions require excision is not known at this time.

Mucosal cysts of the maxillary sinus: a literature review.

The aim of this article is to review the clinical, radiographic and microscopic features, as well as the etiopathogenesis, the differential diagnosis and the treatment of mucosal cysts of the maxillary sinus.

Mucocele: reporte de un caso / Mucocele

Se presenta el caso de una paciente de 65 años de edad, con una tumoración en el seno frontal derecho con las características clínicas de un Mucocele. Se señala la utilidad del TAC para el diagnóstico y determinación de las exactas relaciones de la tumoración con las estructuras vecinas, en especial al contenido orbitario y la fosa cerebral anterior. Se especifica que en este tipo de tumoración la técnica de abordaje utilizada es la más correcta para garantizar la exéresis total de la tumoración sin que queden alteraciones estéticas en la paciente(AU)

Mucocele bilateral de la glándula de Bartholin / Bilateral mucocele of the Bartholin's gland

Se presenta el primer caso en Venezuela de mucocele bilateral de la glándula de Bartholin. Se hace una revisión de la literatura en cuanto a la frecuencia y probable causa de esta patología

[Giant appendiceal mucocele. Apropos of a case]. / Mucocèle appendiculaire géant. A propos d'un cas.

One case of giant appendiceal cyst secondary to obstruction is presented. The clinical feature is a pseudotumoral syndrome with the discovery of a cyst of the right iliac fossa by a pre-menopause woman. It is pre-operatively misdiagnosed as an ovarian cyst. Only an appendectomy is made for this benign lesion. The mucoceles of the appendix are rare, considered as an entity of macroscopic anatomy. The review of the literature allow us to recall the histologic classification of these lesions, their diagnostic patterns and their treatment.

MUCOCELE: UN QUISTE DE RETENCION

Introducción, Generalidades, Consideraciones generales del mucocele, Relación estadistica de patología, Historia clínica, Conclusiones, Bibliografia

[Appendiceal mucocele]. / Il mucocele appendicolare.

The authors, starding from their own clinical casuistry, critically review the literature, and suggest a new classification of appendicular mucocele based upon the anatomo-pathological aspects. They, moreover, analyse the clinical-therapeutical aspects, and hope the histologic testing of appendix becomes a routine practise.

Tumors of the appendix: I. Neoplastic and nonneoplastic mucoceles.

We reviewed the clinical data and pathologic material on 46 patients with lesions originally interpreted as appendiceal mucocele or mucinous adenocarcinoma from two medical centers. The mucoceles, characterized by accumulation of mucus in a dilated lumen, could be divided into three distinct entities: nonneoplastic retention mucoceles (eight cases), cystadenomas (26 cases), and cystadenocarcinomas (eight cases). There were four mucinous adenocarcinomas. Retention mucoceles are associated with little morbidity and are cured by appendectomy. Cystadenomas and cystadenocarcinomas mimic the behavior of ovarian neoplasms of borderline malignant potential. Some of these lesions were associated with pseudomyxoma peritonei, but did not have systemic metastases. Mucinous adenocarcinomas without mucocele mimic the behavior of ordinary large bowel carcinoma.

The CT classification of ethmoid mucoceles.

The computed tomography (CT) appearance of mucoceles involving the ethmoid sinuses is presented. A classification based on the growth patterns of these mucoceles is proposed, and a differential diagnosis for each group is suggested. The unique CT appearance of the ethmoid polypoid--mucocele is described for the first time, and the radiographic definition of a mucocele is discussed.

Salivary mucoceles.

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.