ISSN : 0976-951X

MUCOCELE: MUCOUS EXTRAVASATION PHENOMENON A CASE REPORT

Dr.Kinjal Rindani
Dr. Jigar Purani
Dr. Grishma Doria
Dr. Rina Mehta
Dr. Himani Tiwari
Dr. Bhupesh Patel
Dr. Jitendra Rajani

M.D.S.
M.D.S.
M.D.S.
M.D.S.
M.D.S.
M.D.S.
M.D.S.

Abstract:
Mucocele is a common lesion of the oral mucosa involving salivary glands and their ducts. It is mainly of traumatic origin,
formed when the main duct of a minor salivary gland is torn followed by subsequent extravasation of the mucus into the
connective tissue producing a cyst like cavity. This article reports a case of mucocele of the minor salivary gland of a lower
lip, the most common site of the oral cavity.
Key words: Mucocele, Mucous extravasation phenomenon, Lower lip, Minor salivary gland, Pseudocyst
Introduction:
The mucocele is one of the most common of the benign soft
tissue masses that occur in the oral cavity. Mucoceles
(Mouco-mucus and coele-cavity), by definition, are cavities
filled with mucus.1 They are described as either the
extravasation type or the retention type. The mucous
extravasation phenomenon is the term used when the
spillage of mucin into the connective tissue around the gland.2
The term mucous retention cyst is used to describe a cyst
with retained mucin which is lined by ductal epithelium.3
Mucoceles are most commonly found on the lower lip, lateral
to the midline and are usually single in number. It is mainly of
traumatic origin and are commonly observed in all decades of
life, with increased frequency in children and young adults,
because of higher chances of trauma.4

surgery the operative site healed uneventfully and 6 month

follow up revealed no recurrence.

Illustration 1 Intraoral photograph of a patient exhibits

smooth, translucent swelling on the inner surface of lower lip.

Case Report

The gross examination revealed a fluid filled cystic mass of

approximately of 0.5 cm in diameter with soft consistency and
of cream colour.

A 20 year old male visited faculty of dental science, nadiad

with the chief complaint of a swelling in the inner surface of
lower lip since last one month and was asymptomatic. Patient
did not present with any relevant medical history. Patient had
a habit of lip biting. Intra oral examination revealed a bluish,
fluctuant, non ulcerated mass of about 0.5 cm in diameter in
size and was painless in nature. Patient was referred to the
Oral surgery department and the surgical removal of the
whole lesion was performed under local anesthesia. The
tissue was sent to the department of Oral pathology for the
histopathologic diagnosis. (Illustrations 1, 2) Following

Illustration 2 post operative gross appearance of the lesion.

Lecturer
Reader
Professor & Head
Professor
Department of Oral Pathology
Faculty of Dental Science
Dharmsinh Desai University, Nadiad-387 001.

Address of correspondence:
Dr. Kinjal Rindani
Department of Oral Pathology
Faculty of Dental Science
Dharmsinh Desai University
Nadiad-387 001. Contact No.: 9913306611
e-mail: drkinjalrindani@gmail.com

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ISSN : 0976-951X
Hematoxylin and Eosin stained section showed a cavity
containing eosinophilic mucinous material and lined by
compressed fibrous tissue as well as granulation tissue with
fibroblasts, few blood vessels and acute and chronic
inflammatory cells. (Illustration 3)

Illustration 3 A cystic cavity surrounded by condensed

granulation issue and the surface epithelium.( H & E stain, 4 X)
Minor salivary gland ducts were also present in the proximity
to the cavity; few of them were filled with mucinous material.
(Illustrations 4, 5)

Illustration 4,5 Minor salivary gland duct, One is filled with

eosinophilic mucinous material
Parakeratinized stratified squamous epithelium of the labial
mucosa was present on the surface of the lesion. (Illustration 3)
Discussion
Mucoceles may be located either as a fluid filled vesicles or
blister in the superficial mucosa or as a fluctuant nodule deep
into the connective tissue. Spontaneous drainage of the
mucin followed by subsequent recurrence may occure.5
Mucoceles have no age predilection but mainly occur in the
children and young adults due to more chances of trauma.
The lower lip is reported to be the most common site where
the maxillary canine impinges on it followed by tongue. Less
common sites for the occurrence are buccal mucosa, anterior
lateral tongue, floor of mouth. 4 In our case the site of the
lesion is lower lip.
The lesions are painless, asymptomatic swellings with a
rapid onset and fluctuant nature. The patient may relate a

JOURNAL OF DENTAL SCIENCES

history of trauma or a habit of lip biting. These vesicles

rupture spontaneously and leave ulcerated surface that heals
within a few days. Their deep blue colour results from tissue
cyanosis and vascular congestion associated with the
stretched overlying tissue and translucent character of the
accumulated mucin beneath. The variation of the colour
depends upon the size of the lesion, its proximity to the
mucosal surface and the elasticity of the overlying tissue.3 In
the present case, the patient gives history of trauma and the
lesion is asymptomatic and of fluctuant nature.
Extravasation mucoceles are pseudocysts without defined
epithelial lining. The extravasated mucous is surrounded by a
layer of mixed inflammatory cells and granulation tissue.6
Presence of fibrous tissue is of considerable importance in
limiting the spread of the mucous. Increased amyladase
activity and to a lesser extent alkaline phosphatase activity
have been reported with fibroblasts in the extravasated
mucoceles and may be a manifestation of increased
fibroblastic activity. 7 Our case also gives similar
histopathologic picture of a psuedocyst.
The lesion can be clinically diagnosed as vascular lesions,
pyogenic granuloma, polyp or squamous papilloma
depending upon the degree of vascularity, acinic atrophy,
hemangioma, lymphengioma, lipoma. Superficial mucoceles
are also confused with Cicatrical pemphigoid, Bullous lichen
planus and minor apthous ulcer. A history of trauma, rapid
onset, alteration in size, bluish colour, fluid filled consistency
are helpful in clinical diagnosis of the mucocele.8
Surgical excision with removal of the involved accessory
salivary gland should be done to avoid the recurrence. The
excised tissue should always be submitted for the
pathological investigation to confirm the diagnosis and to rule
out other pathology of the salivary glands.
Referances
 Gupta Bhavna, Anegundi R., Sudha P., Gupta Mohit
Mucocele: Two case reports J Oral Health Comm Dent
2007;1(3): 56-58
 Kheur Supriya, Desai Rajiv, Kelkar Chintamani Mucocele
of lingual salivary glands( Glands of Blandin & Nunh)
 Ata-Ali J, Carrillo C, Bonet C et al Oral mucocele: Review
of the literature J Clin Exp. Dent 2010; 2 (1):10-13
 Yamasoba T, Tayama N., Syoji M., Fukuta M.,
Clinicostatastical study of lower lip mucoceles. Head
Neck. 1990; 12:316-20
 Boneu-Bonet F.,Vidal Homes E.,Maizcurrana
A.,GonzalezLagunas J. Submandibular gland
mucocele: presentation of a case. Med Oral pathol oral
Cir Bucal. 2005;10:180-4
 Baurmash HD, Mucoceles and ranulas. J oral Maxillofac
Surg. 2003; 61: 369-78
 Shafer's textbook of oral rathology 6th edition 2005; 747749.
8. Jinbu Y.,Tsukininoki K.,Kusama M., Watanbe Y. Recurrent
multiple superficial mucocele of the palate ; histopathology
and laservaporization. OOO 2003;95(2): 193-97

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