What does a mucocele result from?
Rupture of a salivary gland duct with spillage of mucin into the connective tissue
Who do mucoceles most commonly occur in?
Children and young adults
Most common location of mucoceles
Lower Lip (60%), buccal mucosa, ventral tongue, floor of the mouth
Histopathologic features of a mucocele
- Spilled mucin surrounded by granulation tissue
- Ruptured salivary gland duct may be evident
- Adjacent salivary glands often contain a chronic inflammatory reaction
Treatment and prognosis of a mucocele
- May rupture and heal spontaneously
- Local surgical excision
- Adjacent minor glands should be removed
- Prognosis is excellent but may recur
What is a ranula?
Mucocele that occurs in the floor of the mouth
What causes a ranula?
Spillage of mucin from the sublingual gland
Where is a ranula located?
Lateral to the midline
What is a plunging or cervical ranula?
Spilled mucin is located below the mylohyoid muscle; may or may not have swelling in the floor of the mouth
Histopathologic feature of a ranula
- Similar to a mucocele
- Spilled mucin elicits a granulation tissue response
Treatment and prognosis of a ranula
Removal of the feeding sublingual gland and/or marsupilization
What characterizes a cyst?
Lined by epithelium
What causes a salivary duct cyst?
Most cases represent ductal dilation secondary to ductal obstruction
Who do salivary duct cysts occur in?
Adults
Where do salivary duct cysts occur?
Major glands: parotid
Minor glands: floor of the mouth, buccal mucosa, lips
Histopathologic features of a salivary duct cyst
- Cystic cavity lined by cuboidal, columnar, or atrophic squamous epithelium
- Lumen contains mucoid secretions
- Lining epithelium may undergo oncocytic metaplasia
Treatment and prognosis of salivary duct cyst
- Conservative surgical excision
- Major gland lesions: partial or total removal of the gland
- Recurrence is rare
What is sialolithiasis?
Calcified structures within the ductal system
What causes sialolithiasis?
Deposition of calcium salts around a nidus of debris: mucus, bacteria, epithelial cells, foreign body
Most common location of sialolithiasis and why?
- Submandibular gland because the duct is long and tortuous and the secretions are thicker and more mucoid in consistency
- Also seen in the glands of the upper lip or buccal mucosa
Who does sialolithiasis occur in?
Young and middle aged adults
What symptoms accompany sialolithiasis?
Asymptomatic or associated with pain or swelling at mealtime
How does a sialolith appear on an x-ray?
Radiopaque mass
Histopathologic features of sialolithiasis
- Concentric laminations around a central nidus of amorphous debris
- Ductal metaplasia or sialadenitis
