الملخص
Los mucoceles son lesiones de extravasación salival asociados a la ruptura de los conductos que generalmente se asocian con trauma. Son azuláceos, con aspecto traslúcido, fluctuantes a la palpación, expansivos y de crecimiento rápido. Mayoritariamente se manifiestan en población joven. El sitio más común de localización es la mucosa de labio inferior, sin embargo, pueden presentarse en cualquier zona que contenga glándulas salivales menores, como vientre de lengua, donde se encuentran las glándulas Blandin-Nuhn. La frecuencia de las lesiones asociadas a éstas glándulas es del 2.25% reportándose aproximadamente 400 casos hasta la fecha. La finalidad de ésta publicación es la descripción de una patología infrecuente, así como realizar una revisión a la literatura. Se presenta el caso de una niña de tres años con historia de aumento de volumen congénito en el dorso de la lengua sin síntomas compatibles con mucocele, se realiza biopsia excisional bajo anestesia general. El resultado del estudio histopatológico reporta: fenómeno de extravasación de mucosa. Paciente evoluciona satisfactoriamente. Estas lesiones expansivas pueden repercutir en el desenvolvimiento normal de la vida de las personas causando dislalia, disfagia y disnea. El tratamiento de este tipo de lesiones en la infancia favorece a un adecuado desarrollo del habla y mejora las condiciones de alimentación.
Mucoceles are salivary extravasation lesions associated with rupture of ducts that are generally associated with trauma. They are bluish, translucent in appearance, fluctuating on palpation, expansive and fast growing. They mostly occur in young people. The most common site of location is the mucosa of the lower lip, however, they can occur in any area that contains minor salivary glands, such as the belly of the tongue, where the Blandin-Nuhn glands are located. The frequency of lesions associated with Blandin-Nuhn's glands is 2.25%, with approximately 400 cases reported to date. The purpose of this publication is the description of an uncommon pathology, as well as a review of the literature. The case of a three-year-old female with a history of congenital volume increase at the dorsum of the tongue without symptoms compatible with mucocele is reported, an excisional biopsy was performed under general anesthesia. The result of the histopathological study reports: extravasation mucus phenomenon. Patient evolves satisfactorily. These expansive lesions can affect the normal development of people's lives, causing dyslalia, dysphagia and dyspnea. Treatment of this type of injuries in childhood favors adequate speech development and improves feeding conditions.
الملخص
Objective To report the clinical features,imaging findings and endoscopic dacryocystosinostomy(En-DCR)of acquired lacrimal sac mucocele(ALSM).Methods 63 patients(63 eyes)with ALSM treated with En-DCR combined with bicanalicular silicone tube intubation from January 2016 to March 2021 were reviewed.The clinical features,imaging findings,and surgical treatment of the included patients were analyzed by preoperative examination and 12 month postoperative follow-up.Fifty-seven patients(21 males and 36 females)were enrolled in this study at last,including 30 right eyes and 27 left eyes,25～71 years old,with an average age of(52.89±11.66)years old.All eyes with history of epiphora and purulent secretion.Results CT examination revealed enlargement of the lacrimal sac,but no destruction of the adjacent bone.MRI imaging showed enlargement of the lacrimal sac,fluid collection separated from adjacent tissues by a thin rim,corresponding to mucocele in the sac and increase in the sac diameters in all analyzed cases.The mass was found to shrink significantly when the lacrimal sac was opened during the surgery,and the swelling was completely relieved within 7 days post-operation.After 12 months of follow-up,the anatomical success rate of En-DCR was 92.98%(53/57),the functional success rate was 89.47%(51/57),no complications such as mucocele recurrence,diminution of vision and infection were found.Conclusion All the patients with ALSM had a history of previous lacrimal duct obstruction.Imaging examinations are valuable for the diagnosis of ALSM.En-DCR for ALSM is safe and effective,and worthy of clinical promotion.
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ABSTRACT A 42-year-old female patient had vision loss and chronic epiphora in her left eye. Her best-corrected visual acuity was 10/10 in the right eye and 0.3/10 in the left eye. The anterior segment examination results were normal. In fundus examination, choroidal folds were detected. Optical coherence tomography showed elevation on the macula and choroidal folds. Ultrasonography revealed a T-sign. Magnetic resonance imaging revealed an ethmoidal mucocele that compresses the orbital tissues. Surgical treatment was performed in the otorhinolaryngology department. Postoperatively, choroidal folds recovered, and the best-corrected visual acuity improved, but subretinal fluid accumulated. During the follow-up period without any treatment, subretinal fluid totally disappeared.
RESUMO Paciente do sexo feminino, 42 anos, com perda visual e epífora crônica no olho esquerdo. Sua acuidade visual melhor corrigida foi de 10/10 no olho direito e 0,3/10 no olho esquerdo. O exame do segmento anterior foi normal. No exame de fundo de olho, foram detectadas pregas coroidais. A tomografia de coerência óptica revelou elevação na mácula e pregas coroidais. A ultrassonografia revelou sinal T. A imagem de ressonância magnética mostrou mucocele etmoidal que comprime os tecidos orbitários. O Departamento de Otorrinolaringologia realizou o tratamento cirúrgico. No pós-operatório, as dobras coroidais se recuperaram, a acuidade visual melhor corrigida foi melhorada, mas ocorreu líquido sub-retiniano. Durante o período de acompanhamento sem qualquer tratamento, o líquido sub-retiniano recuperou-se totalmente.
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ABSTRACT We present an unusual case of a 13-year-old male pediatric patient with a diagnosis of sphenoid sinus mucocele. The patient suffered a progressive loss of visual acuity over three months followed by a total recovery of his visual acuity after surgery. The patient presented at the emergency room complaining of progressive loss of visual acuity in his left eye which decreased to hand motion over the preceding months. Imaging studies revealed a cystic mass, suggestive of sphenoid sinus mucocele, which was causing compressive optic neuropathy and proptosis. The patient was scheduled for a sphenoidectomy and resection of the mass. Three days after surgery, the patient's visual acuity in the left eye was 20/20, indicating complete recovery from his symptoms. We suggest that the excellent outcome in this patient may be attributable to his age. His ongoing physical development might have been the decisive factor in the recovery of his visual acuity following compressive optic neuropathy secondary to sphenoid sinus mucocele. Further research is needed to verify this proposed explanation.
RESUMO Apresentamos um caso incomum de paciente pediátrico com diagnóstico de mucocele de seio esfenoidal, que apresentou perda progressiva da acuidade visual ao longo de três meses, resultando em recuperação total da acuidade visual após a cirurgia. Paciente do sexo masculino, 13 anos, procurou o pronto-socorro, queixando-se de perda progressiva da acuidade visual do olho esquerdo nos últimos três meses. Exames de imagem revelaram uma massa cística sugestiva de mucocele de seio esfenoidal, causando neuropatia óptica compressiva e proptose. O paciente foi agendado para esfenoidectomia e ressecção da massa. Três dias após a cirurgia, a acuidade visual do paciente no olho esquerdo era de 20/20, apresentando recuperação completa dos sintomas. Diante dos resultados de nosso paciente, sugerimos que a idade do paciente pode ser decisiva na recuperação da acuidade visual de uma neuropatia óptica compressiva secundária à mucocele de seio esfenoidal. Mais pesquisas são necessárias para verificação desses dados.
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Resumen Caso clínico sobre un paciente masculino, 35 años, deportista, conocido sano, que presenta una historia clínica con síntomas gastrointestinales indeterminados, a quien se le realizan estudios complementarios, detectándose una lesión fusiforme, de apariencia quística, con contenido seroso, de aproximadamente 9cm, perteneciente al apéndice ileocecal. Inicialmente, debido a los hallazgos, en los estudios realizados a nuestro paciente, se sospecha de mucocele apendicular. Según la teoría el mucocele apendicular se origina de una obstrucción del apéndice ileocecal, lo cual provoca una acumulación retrograda de material mucinoso y eso ocasiona una dilatación de la luz apendicular, convirtiéndose en una masa quística. Con dicho diagnóstico presuntivo, se realiza apendicectomía con hemicolectomía derecha. El abordaje quirúrgico que se decide para este caso es la cirugía abierta versus laparoscópica, debido al riesgo de cistoadenocarcinoma mucinoso. Posteriormente se envía la lesión para realización de estudio patológico, donde se evidencia una neoplasia mucinosa de bajo grado del apéndice.
Abstract Clinical case of a 35-year-old male patient, an athlete, known to be healthy, who presented a clinical history with indeterminate gastrointestinal symptoms, who underwent complementary studies, detecting a fusiform lesion with a cystic appearance, with serous content, approximately 9cm, belonging to the ileocecal appendix. Initially, due to the findings in the studies carried out on our patient, an appendiceal mucocele was suspected. According to the theory, the appendicular mucocele originates from an obstruction of the ileocecal appendix, which causes a retrograde accumulation of mucinous material and this causes a dilation of the appendicular lumen, becoming a cystic mass. With this presumptive diagnosis, appendectomy with right hemicolectomy was performed. The surgical approach chosen for this case is open versus laparoscopic surgery, due to the risk of mucinous cystadenocarcinoma. Subsequently, the lesion is sent for a pathological study, where a low-grade mucinous neoplasm of the appendix is evidenced.
الملخص
The cecal appendix mucocele is considered a cystic dilation of obstructive etiology that produces an accumulation of mucoid substance. It may be of benign or malignant origin. 50-year-old female, with no significant personal pathological history, presents with repetitive clinical symptoms of abdominal pain, similar to the process of acute appendicitis, without systemic inflammatory response data, which improves with analgesic management, is protocolized by laboratory studies and imaging, diagnosing appendicular tumor, so it is protocolized for surgical resolution, during which it is decided to do right hemicolectomy due to the macroscopic features of ascending colon. The clinical course and prognosis of mucinous appendicular lesions are closely related to their histology and the presence and extent of peritoneal dissemination. With a survival of 91 to 100% after a conventional appendectomy. The cecal appendix mucocele is considered a benign neoplasm; with good survival provided it is diagnosed in time and an appropriate surgical approach is performed; in our case fortunately it could be protocolized correctly; perform a surgical resection with free edges of oncological cells confirmed by histopathology, so our patient could be discharged from the service being free of oncological pathology at this time.
الملخص
Appendiceal mucocele is a rare pathology of the appendix that can present with non-specific symptoms. Therefore, imaging evaluation is essential for accurate diagnosis and proper management. To document importance of pre-operative imaging, we reviewed the scans, reports, and clinical data of nine patients with appendiceal mucocele who were treated at our institute. We also studied the literature on CT findings, histopathology, surgical management, prognosis, and recent guidelines for appendiceal mucocele. We suggest that pre-operative imaging can aid surgeons in selecting the most appropriate treatment plan for each patient, resulting in better outcomes. Certain critical imaging features, such as mural nodularity, irregular wall thickening, lymphadenopathy, cecal involvement, presence of free mucus, or pseudomyxoma peritonei, can alert surgeons to prepare for frozen section and an appropriate surgical approach. In conclusion, we recommend pre-operative imaging as a crucial tool for the diagnosis and management of appendiceal mucocele. Its use in identifying critical imaging features can help surgeons decide on the best surgical approach for each patient and ultimately lead to better outcomes.
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Introducción: la cefalea rinogénica es secundaria al contacto permanente de la mucosa nasal y puede ser secundario a concha bullosa, si se infecta puede ser mucocele o mucopiocele. Caso clínico: paciente de 34 años con cefalea hemicraneal izquierda, dolor periocular ipsilateral, congestión y rinorrea hialina con cambios en consistencia y coloración del moco. En la tomografía computarizada (TAC) de senos paranasales (SPN) desviación septal derecha por concha bullosa izquierda, ocupación de líquido. Se sospecho mucocele y cefalea rinogénica secundaria, prueba de lidocaína positiva. Se detecto por cultivo, Eikenella corrodens. Manejo con antibiótico y posterior resolución de patología. Conclusiones: debe incluirse en el diagnóstico diferencial de cefalea y concha bullosa, realizarse endoscopia nasal y TAC de SPN. El manejo quirúrgico ha demostrado reducir la intensidad y la frecuencia de la cefalea a corto y largo plazo, y es exitoso si hay test de lidocaína positivo.
Introduction: rhinogenic headache is secondary to permanent contact with the nasal mucosa and may be secondary to concha bullosa, if infected it may be mucocele or mucopiocele. Clinical case: 34-year-old patient with left hemicranial headache, ipsilateral periocular pain, congestion, and hyaline rhinorrhea with changes in consistency and coloration of the mucus. In the computed tomography (CT) of the paranasal sinuses (SPN) right septal deviation due to left concha bullosa, fluid occupation. Mucocele and secondary rhinogenic headache were suspected, lidocaine test positive. Eikenella corrodens was detected by culture. Management with antibiotics and subsequent resolution of pathology. Conclusions: nasal endoscopy and SPN CT should be included in the differential diagnosis of headache and concha bullosa. Surgical management has been shown to reduce headache intensity and frequency in the short and long term, and is successful if there is a positive lidocaine test.
الموضوعات
Humans , Male , Female , Headache , Mucocele , Turbinates , Rhinorrhea , Nasal Mucosaالملخص
Introducción: El mucocele apendicular se considera una lesión rara del apéndice que se caracteriza por la dilatación de la luz del órgano con acumulación de moco. Este puede ser benigno o maligno. Objetivo: Caracterizar un caso de mucocele apendicular de comportamiento benigno en un paciente adulto masculino. Presentación del caso: Se asiste a un paciente, en estudio de tumor de vías digestivas, que se interviene quirúrgicamente con cuadro peritoneal agudo hallando masa de localización apendicular. Se realiza apendicectomía convencional y se estudia la pieza por anatomía patológica como mucocele apendicular benigno. La evolución del paciente fue satisfactoria. Conclusiones: Se presenta clínicamente de forma inespecífica, lo que posibilita que su diagnóstico sea intraoperatorio con mayor frecuencia. La estrategia quirúrgica depende de los hallazgos intraoperatorios donde la apendicectomía y la hemicolectomía derecha son las técnicas más utilizadas. El pseudomixoma peritoneal es una complicación temida(AU)
Introduction: Appendiceal mucocele is considered a rare lesion of the appendix characterized by dilatation of the organ lumen with mucus accumulation. It can be benign or malignant. Objective: To characterize a case of appendiceal mucocele with benign behavior in an adult male patient. Case presentation: A patient under study of digestive tract tumor is attended. The patient underwent surgery for having acute peritoneal symptoms; a mass of appendicular location was found. Conventional appendicectomy was performed and the piece was studied by pathological anatomy, being a benign appendicular mucocele. The patient's evolution was satisfactory. Conclusions: This condition is presented clinically in a nonspecific manner, which makes for its diagnosis to be more frequently intraoperative. The surgical strategy depends on the intraoperative findings, in which appendectomy and right hemicolectomy are the most used techniques. Pseudomyxoma peritonei is a feared complication(AU)
الموضوعات
Humans , Mucocele/diagnosisالملخص
ABSTRACT Despite being common pathological entities found in the oral cavity, oral mucoceles can present distinct features, raising several diagnostic possibilities and treatments. In this study, we report the case of a 34-year-old man with an asymptomatic increased volume in the left periorbital region of more than a year, without remission or associated trauma. An aspiration biopsy was performed, followed by an excisional biopsy, and the specimen was sent for histopathological examination. Results led to the diagnosis of an oral mucocele. Surgical removal was performed in an excisional biopsy. Subsequently, the patient recovered promptly without further complications. Although oral mucoceles recur relatively often, its prognosis is good. This case emphasizes the importance of obtaining a detailed disease history, knowledge of its clinical features, and etiopathogenesis combined with complementary examinations to establish diagnostic hypotheses and converge on an adequate and individualized treatment plan
RESUMO Apesar de serem entidades patológicas comumente encontradas na cavidade oral, as mucoceles podem apresentar características distintas, o que pode sugerir diversas possibilidades diagnósticas e de tratamento. Paciente do gênero masculino, 34 anos, compareceu ao ambulatório com queixa de aumento de volume assintomático na região periorbitária esquerda há mais de um ano, sem remissão ou trauma associado. Foi realizada biópsia aspirativa seguida de biópsia excisional e a amostra encaminhada para exame histopatológico, que confirmou o diagnóstico de mucocele oral. O paciente evoluiu sem queixas e sem recidiva. Apesar da alta taxa de recorrência, mucoceles orais têm um bom prognóstico. Este relato de caso enfatiza a importância da obtenção de uma história detalhada da doença, do conhecimento de suas características clínicas e da etiopatogenia, para estabelecer hipóteses diagnósticas e convergir para um plano de tratamento adequado e individualizado.
الملخص
Background: Oral mucocele are common non neoplastic lesions of the oral cavity that develop either as a result of damage to the duct or obstruction to the duct of minor salivary gland. Histopathologically oral mucoceles are divided into two categories: Extravasation mucoceles often seen in young individuals, the lower lip being the classic location. The second category includes retention mucoceles, which occurs most often in older patients usually located in the floor of the mouth and the inside the cheek. Objectives: This study aims to describe the demographic and histological characteristics of Oral mucocele along with com- parative study between Extravasation mucocele and Retention Mucocele. Method: A total of 32 cases of mucocele diagnosed in the Department of the Pathology, between 2012 and 2019 were re- viewed. The clinical data were recorded and histopathologic diagnosis was made. The study variables included were age, gen- der, type, site, color, etiology, symptoms and dimension of the lesion. Results: A total of 32 cases of oral mucocele cases were studied corresponding to a M:Fratio of 1.13:1. Peak incidence occurred in third decade followed by equally in the first and second decades of life. Extravasation Mucocele was the clinical diagnosis in 59.4% and Retention Mucocele in 40.6%. Most lesions were located in the lower lip (59.3%). Conclusion: This study provides an important insight into demographic and histological profile of oral mucocele lesion. It was concluded that oral mucocele predominantly presented in two histological forms, Extravasation Mucocele which was more common than other lesser common form Retention Mucocele. Although these lesion are easily diagnosed on the basis of clini- cal presentation but sometimes these swelling can mimic other benign mucosal lesion of these region, hence histopathologi- cal examination must be done in order to rule out these lesion and also to note any variation from its normal morphological findings.
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Resumen Los mucoceles del apéndice son raros, predominan en mujeres y suelen presentarse como una masa palpable en el cuadrante inferior derecho. La mayoría de los pacientes son asintomáticos. El mucocele se define como una dilatación quística de la luz apendicular causada por la acumulación de mucina. Se presenta el caso de un paciente del sexo masculino en la séptima década de la vida, con cuadro clínico de abdomen agudo con sospecha de apendicitis aguda. Se realizó intervención quirúrgica laparoscópica de hemicolectomía tras encontrar hallazgos de tumoración dependiente de colon ascendente (región de ciego), indurada de 80 × 100 mm aproximadamente, realizando hemicolectomía derecha más anastomosis ilecolónica lateroterminal con adecuada evolución postquirúrgica.
Abstract Mucoceles of the appendix are rare, predominate in women and usually present as a palpable mass in the right lower quadrant. Most patients are asymptomatic. The mucocele is defined as a cystic dilatation of the appendicular lumen caused by mucin accumulation. We present the case of a male patient in his seventh decade with clinical symptoms of acute abdomen with suspicion of acute appendicitis, laparoscopic hemicolectomy surgery was performed after finding findings of tumor dependent on ascending colon (blind region), indurated 80 × 100 mm approximately, performing right hemicolectomy plus ileocolonic lateroterminal anastomosis with adequate postoperative evolution.
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Proptosis, the forward protrusion of the eyeball, is a common manifestation of a wide variety of diseases inside the orbit and its spaces. The causes of unilateral proptosis are innumerable and its evaluation requires a multidisciplinary approach. Paranasal sinus mucoceles are epithelium-lined cystic masses usually resulting from obstruction of sinus ostia. The close proximity of paranasal sinus mucoceles to the orbit and skull base predispose patients to significant morbidity. Primary ethmoid mucocele is an uncommon entity, especially in the absence of prior ear, nose and throat complaints, and therefore should remain an important differential when a patient presents with a unilateral swelling causing proptosis. Herein, we report an unusual case of a primary frontoethmoid mucocele in a 35 years old woman who presented with a painless swelling with an obvious displacement of the left eye since 1 year, associated with restriction of ocular movements, thus prompting radio imaging of orbits. The results showed a large well-defined expansile lesion suggestive of Left Eye frontoethmoidal mucocele, prompting an immediate surgical referral.
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Abstract Oral mucocele (OM) is the most common lesion of minor salivary glands. The present study aimed to report the clinical and demographic features of a large series of OMs and identify possible predictive variables associated with the recurrence rate of these lesions. A retrospective descriptive cross-sectional study was performed. A total of 43,754 biopsy records from four pathology services in Brazil were analyzed. All cases of OMs were reviewed, and clinical and demographic data were collected. The study comprised 1,002 females (56.2%) and 782 males (43.8%), with a mean age of 19.8±16.4 years (range: 01-87 years) and a 1.3:1 female-to-male ratio. The lower lip (n=1,160; 67.4%), and floor of the mouth (n=172; 10.0%), were the most common affected sites, presenting clinically as nodules (n=978; 79.4%) of smooth surface (n=428; 77.5%) and normal color (n=768, 46.7%). Excisional biopsy was the treatment in most cases (n=1,392; 78.0%). Recurrent OMs represented 6.2% of all diagnosed cases (n=117). OMs recurred more commonly in younger patients (aged<20 years) (p<0.0001), in lesions larger than 2 cm in diameter (p<0.0001), and in those located in the ventral tongue (p=0.0351). Also, recurrence rates were higher significantly in cases treated with laser surgery than in those with conventional surgery (p=0.0005). Patients with OMs should be carefully informed of its possible recurrence, especially when found on the ventral tongue of young patients.
Resumo A mucocele oral (MO) é a lesão mais comum das glândulas salivares menores. O presente estudo teve como objetivo relatar as características clínicas e demográficas de uma grande série de MOs e identificar possíveis variáveis preditivas associadas à taxa de recorrência dessas lesões. Foi realizado um estudo transversal descritivo retrospectivo. Foram analisados 43.754 registros de biópsias de quatro serviços de patologia no Brasil. Todos os casos diagnosticados como MOs foram revisados e dados clínicos e demográficos foram coletados. Participaram do estudo 1.002 mulheres (56,2%) e 782 homens (43,8%), com média de idade de 19,8 ± 16,4 anos (variação: 01-87 anos) e proporção de mulheres para homens de 1,3:1. O lábio inferior (n=1.160; 67,4%) e assoalho da boca (n=172; 10,0%), foram os locais mais acometidos, apresentando-se clinicamente como nódulos (n=978; 79,4%) de superfície lisa (n =428; 77,5%) e coloração normal (n=768, 46,7%). A biópsia excisional foi o tratamento na maioria dos casos (n=1.392; 78,0%). As MOs recorrentes representaram 6,2% de todos os casos diagnosticados (n = 117). As recorrências recorreram mais comumente em pacientes mais jovens (idade < 20 anos) (p < 0,0001), em lesões maiores que 2 cm de diâmetro (p < 0,0001) e naquelas localizadas na superfície ventral da língua (p = 0,0351). Além disso, as taxas de recorrência foram significativamente maiores nos casos tratados com cirurgia a laser do que aqueles com cirurgia convencional utilizando bisturi (p = 0,0005). Pacientes com mucoceles devem ser informados sobre uma possível recorrência, principalmente quando encontrados no lábio ou assoalho bucal de pacientes jovens.
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Pathologies developing on the floor of the mouth create difficulty for the patient and pose a challenge to oral physicians both clinically and surgically as this area manifests numerous vital structures. While diagnosing, an accurate differential diagnosis should be established to rule out other lesions that usually occur on the floor of the mouth such as ranula, lipoma, salivary gland tumours, dermoid cyst, and vascular lesions. Cystic lesions developing from the salivary glands are commonly known as "mucoceles", these lesions develop mostly in relation to the minor salivary glands and rarely, in relation to the major salivary glands. Mucoceles basically are of two types: Mucous retention cyst and Mucous extravasation cyst. A Ranula is a form of mucous extravasation cyst which commonly occurs on the floor of the mouth. Deep seated lesions when herniate through mylohyoid muscle give rise to a clinical variant; plunging or cervical Ranula. Various treatment modalities for ranula has been suggested that include excision of lesion with or without excision of ipsilateral sublingual salivary gland, marsupialization, aspiration of cystic fluid, sclerotherapy, incision and drainage and many more. Those various treatments have shown diverse results. Here we present a case report and review of Sublingual Ranula in a 47-year-old female patient, treated with the excision of the Ranula. A follow-up of 3 months revealed no recurrence.
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Se presenta el caso de un paciente varón de 18 años, con un gran mucocele frontoetmoidal derecho, postoperado en dos oportunidades anteriores, que acudió a nuestro servicio por un empeoramiento de la diplopía. Al examen físico se visualizaba un desplazamiento del globo ocular hacia abajo y afuera. Se le realizó estudios de imágenes, una tomografía computarizada y una resonancia magnética nuclear que sugerían un mucocele frontoetmoidal derecho. Se le realizó una sinusotomía tipo Draf III para drenaje de la lesión, con mejoría de los síntomas.
We present the case of an 18-year-old male patient with a large right frontoethmoidal mucocele, postoperatively on two previous occasions, who came to our department due to worsening diplopia. Physical examination revealed a downward and outward displacement of the eyeball. Imaging studies, computed tomography, and magnetic resonance imaging were performed that suggested a right frontoethmoidal mucocele. A type Draf III sinusotomy was performed to drain the lesion, with improvement of the symptoms.
الموضوعات
Mucocele , Drainage , Diplopiaالملخص
ABSTRACT Mucocele is an inflammatory lesion of the common salivary gland in the oral cavity, generated by the accumulation of saliva, from the rupture of the minor salivary gland duct. The objective of this report was to describe a case of extravasation phenomena treated with high-power diode laser in association with photobiomodulation. The patient presented a nodular, exophytic lesion on the lower lip, similar in color to the mucosa, measuring 2 cm in diameter. Excisional biopsy was performed with high-power diode laser. Immediately after surgery and weekly thereafter, photobiomulation was performed with lower-power diode. After one-month, total repair of the surgical wound was observed, with minimal scarring, without lesion recurrence during 14 months of follow-up. Therefore, the treatment protocol used proved to be an effective, safe and fast alternative, bringing greater comfort to both professional and patient during the trans and postoperative periods.
RESUMEN El mucocele es una lesión inflamatoria de la glándula salival común en la cavidad oral, generada por la acumulación de saliva, a partir de la ruptura del conducto de la glándula salival menor. El objetivo de este reporte fue describir un caso de fenómeno de extravasado tratado con láser de diodo de alta potencia asociado a fotobiomodulación. El paciente presentaba una lesión nodular exofítica en el labio inferior, de coloración similar a la mucosa, de 2 cm de diámetro. Se realizó una biopsia por escisión con un láser de diodo de alta potencia. Inmediatamente después de la cirugía y semanalmente se realizó fotobiomulación con un diodo de menor potencia. Al mes se observó la reparación completa de la herida quirúrgica, con mínima cicatrización, sin recurrencia de la lesión durante 14 meses de seguimiento. Por lo tanto, el protocolo de tratamiento utilizado demostró ser una alternativa eficaz, segura y rápida, creando mayor comodidad para el profesional y el paciente durante el período trans y postoperatorio.
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Abstract Mucoceles of the appendix are rare and can have quite variable imaging and clinical presentations, sometimes mimicking an adnexal mass. The underlying cause can be neoplastic or non-neoplastic. The typical imaging appearance of a mucocele of the appendix is that of a cystic structure with a tubular morphology. This structure is defined by having a blind-ending and being contiguous with the cecum. Radiologists should be familiar with key anatomical landmarks and with the various imaging features of mucoceles of the appendix, in order to provide a meaningful differential diagnosis of a lesion in the right lower abdominal quadrant. In addition, a neoplastic mucocele can rupture, resulting in pseudomyxoma peritonei, which will change the prognosis dramatically. Therefore, prompt diagnostic imaging is crucial.
Resumo Mucoceles do apêndice são raras e podem ter uma apresentação clínica e imagiológica bastante variável, por vezes mimetizando patologia anexial. As causas subjacentes podem ser neoplásicas ou não neoplásicas. O aspecto de imagem típico de mucoceles do apêndice é o de uma estrutura de natureza cística com morfologia tubular. Esta estrutura deverá terminar "em fundo cego" e ser contígua com o ceco. Os radiologistas devem estar familiarizados com os pontos anatômicos de referência e com as diferentes características imagiológicas de mucoceles do apêndice, de modo a fornecer um adequado diagnóstico diferencial de uma lesão localizada no quadrante abdominal inferior direito. Para além disso, uma mucocele neoplásica pode sofrer ruptura, resultando em pseudomixoma peritoneal, o que altera drasticamente o prognóstico. Assim, o diagnóstico por imagem em tempo útil é crucial.
الملخص
O fenômeno de extravasamento de muco, também referido como mucocele, é uma lesão comum da mucosa oral resultante da ruptura de um ducto da glândula salivar com extravasamento da mucina. O principal fator etiológico é o trauma local. A localização mais comum é o lábio inferior, mas outros locais podem ser afetados. Existe a necessidade de diagnóstico diferencial uma vez que, pelo aspecto clínico e localização, as mucoceles assemelham-se a outras lesões que afetam a boca. Diante desse cenário, o objetivo deste trabalho foi relatar dois casos clínicos de fenômeno de extravasamento de muco (mucocele), evidenciando suas características clínicas, histopatológicas, tratamento e prognóstico. Acredita-se que o conhecimento das principais características dessa condição patológica possa auxiliar o clínico na adoção dos principais procedimentos na avaliação, conduta e tratamento desses pacientes.
The mucous retention phenomenon, also called as oral mucocele, is a common lesion of the oral mucosa resulting from the rupture of a salivary gland duct. The main etiological factor is local trauma. The most common location is the lower lip, but other locations can be affected. Differential diagnosis is important because mucoceles resemble other oral lesions. Thus, the aim of the present study was to report two cases of mucocele, demonstrating its clinical and histopathological characteristics, treatment and prognosis.. It is believed that knowledge of the main characteristics of this lesions can help the clinician in carrying out the main procedures in the evaluation, conduct and treatment of these patients.
الموضوعات
Humans , Male , Female , Child , Adult , Mouth , Mucoceleالملخص
La patología tumoral apendicular tiene una incidencia inferior al 0,5% de todos los tumores gastrointestinales, al ser una afección poco frecuente se detalla un análisis de los datos clínicos, imagenológicos y del manejo de la patología. Se presenta el caso de una paciente femenina de 25 años que consulta por dolor abdominal localizado en fosa ilíaca derecha de larga data. Al examen físico impresiona abdomen doloroso a la palpación superficial y profunda en fosa ilíaca derecha, ausencia de signos de irritación peritoneal. En los exámenes complementarios; la tomografía simple y contrastada de abdomen y pelvis evidencia imagen tubular, hipodensa que comienza desde la base del ciego con un calibre aproximado de 29 mm, en relación con mucocele apendicular. Se decide manejo quirúrgico, realizando hemicolectomía derecha por vía laparoscópica, sin ninguna complicación. El reporte histopatológico de la muestra enviada concluye neoplasia mucinosa apendicular de bajo grado. La paciente mostró una evolución postquirúrgica satisfactoria, siendo dada de alta, al día siguiente de su intervención quirúrgica.
Appendicular tumor pathology has an incidence of less than 0.5% of all gastrointestinal tumors, being a rare condition, an analysis of the clinical and imaging data and the management of the pathology is detailed. We present the case of a 25-year-old female patient who consulted for long-standing abdominal pain located in the right iliac fossa. Physical examination revealed a painful abdomen on superficial and deep palpation in the right iliac fossa, with no signs of peritoneal irritation. In the complementary examinations; the simple and contrasted tomography of abdomen and pelvis evidences a tubular image, hypodense that begins from the base of the cecum with an approximate caliber of 29 mm, in relation to appendicular mucocele. Surgical management was decided, performing laparoscopic right hemicolectomy, without any complications. The histopathological report of the sample sent concluded low grade appendicular mucinous neoplasia. The patient showed a satisfactory postoperative evolution and was discharged the day after surgery.
A patologia do tumor apendicular tem uma incidência de menos de 0,5% de todos os tumores gastrointestinais. Por ser uma condição rara, uma análise dos dados clínicos e de imagem e o manejo da patologia é detalhada. Apresentamos o caso de uma paciente feminina de 25 anos de idade que se consultou por dores abdominais de longa data localizada na fossa ilíaca direita. O exame físico revelou um abdômen doloroso à palpação superficial e profunda na fossa ilíaca direita, sem sinais de irritação peritoneal. Nos exames complementares, a tomografia simples e contrastada do abdômen e da pélvis mostrou uma imagem tubular hipodensa, começando na base do ceco com um calibre aproximado de 29 mm, em relação à mucocele apendicular. O gerenciamento cirúrgico foi decidido, realizando uma hemicolectomia laparoscópica direita, sem nenhuma complicação. O relatório histopatológico da amostra enviada concluiu uma neoplasia da mucosa apendiceal de baixo grau. O paciente apresentou uma evolução pós-operatória satisfatória e teve alta no dia seguinte à cirurgia.