Dermatologic Manifestations of Mucocele (Mucous Cyst) Clinical Presentation

Updated: Mar 27, 2019
  • Author: Christopher R Shea, MD; Chief Editor: William D James, MD  more...
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Presentation

History

The clinical presentation varies by the type and the location of the lesion.

People with superficial mucoceles (mucous cysts) may report single or multiple blisters that often spontaneously burst, leaving shallow ulcers. These lesions completely heal within a few days. Sometimes, lesions recur in the same site.

The classic presentation of mucoceles is as a shiny, dome-shaped papule that waxes and wanes over several months.

A mucocele located in the deep soft tissue has a slow growth phase, resulting in a firm, deep mass.

Rare cases have been described in the neck arising from ectopic salivary glands; these lesions are associated with cheilitis glandularis apostematosa.

The appearance of superficial mucoceles as a consequence of chronic graft versus host disease has been reported in patients receiving allogeneic bone marrow transplants. They typically are asymptomatic and therefore may not be identified. [16]

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Physical Examination

The clinical presentation of mucoceles depends on the depth of the lesion.

Superficial mucocele

The mucus accumulates immediately below the mucosa, resulting in small translucent vesicles (0.1-0.4 cm in diameter) on the soft palate, retromolar region, and buccal mucosa.

In time, these vesicles may burst spontaneously or by trauma, leaving shallow ulcers or erosions.

Classic mucocele

This form presents as a collection of mucus in the upper submucosa producing a well-defined, mobile, painless, dome-shaped swelling. These lesions often exhibit a smooth, blue surface. The size varies from a few millimeters to several centimeters in diameter; 75% of the lesions are less than 1 cm in diameter.

Eventually, the surface turns irregular and whitish due to multiple cycles of rupture and healing caused by trauma or puncture.

The most frequent locations are the lower lip, floor of the mouth, cheek, palate, retromolar fossa, and dorsum of the tongue; the upper lip is usually spared.

Larger lesions most often affect the floor of the mouth; these are called ranulas because of the similarity to the throat pouch of frogs. A ranula can extend beyond the oral cavity, even to the upper mediastinum or skull base.

When the mucus accumulates in the deep soft tissues, the presentation is as an enlarging, painless mass assuming the pink coloration of the mucosa.

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