Recurrent bluish swelling of the lower lip in a teenager
15-year-old female
§Chief complaint
Painless bubble on the lower lip that bursts and comes back
§Medical & dental history
- 01Fit and well
- 02Habit of biting the lower lip
§Clinical examination
- 01Dome-shaped, bluish, fluctuant swelling 9 mm on the left lower labial mucosa
- 02Non-tender, no bleeding, mucosa intact
- 03History of rupture with clear viscous fluid discharge and recurrence
- 04No other lesion in the mouth
§ figuresFigures (3)
Fig. 1Surgical removal of a mucocele in the lower lip.
“Surgical removal of a Mucocele.” · Jeffrey Dorfman · CC BY-SA 3.0 · Wikimedia Commons
Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Mucocele figures pending faculty review.
§Differential diagnosis
§Final diagnosis
Mucous extravasation phenomenon (mucocele) of the lower lip
Location on the lower lip, a young patient, a history of lip-biting trauma, and recurrent rupture-and-refill are the discriminators. A haemangioma blanches; a salivary gland tumour is firm and typically palatal.
§Investigations
- 01Clinical diagnosis; transillumination shows a fluid-filled lesion
- 02Excisional biopsy confirms and treats
§Treatment plan
- 01Excision of the mucocele together with the feeding minor salivary glands
- 02Address the lip-biting habit to prevent recurrence
§Surgical procedure
- 01Elliptical incision, lesion dissected with the adjacent minor salivary glands
- 02Careful protection of the mental nerve branches
- 03Primary closure with 5-0 resorbable sutures
§Histopathology report
Mucin pool surrounded by granulation tissue and foamy macrophages without an epithelial lining, with adjacent inflamed minor salivary gland tissue. Mucous extravasation phenomenon.
§Follow-up & outcome
- 01Healed uneventfully
- 02No recurrence at 12 months once habit stopped
§Clinical pearls / learning points
- 01Removing the mucin without the feeding gland guarantees recurrence.
- 02Extravasation mucoceles have no epithelial lining; retention cysts do.
- 03A 'mucocele' on the hard palate or in an older adult should be biopsied as a possible neoplasm.
§References
- Neville BW et al. Oral and Maxillofacial Pathology, 5th ed.
§Similar cases
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