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> Disorders > Anatomical Abnormality > Mucocele

Mucocele

Mucocele: A benign, cystic lesion that occurs due to the accumulation of mucus in a blocked salivary gland duct.
Mucoceles can form in the lips, cheeks, or floor of the mouth, and may appear as a painless, soft, fluctuant swelling.
They typically resolve spontaneously but may recur.
Identification of the best treatment protocols and products for managing Mucocele can be streamlined using PubCompare.ai, an AI-powered research platform that locates relevant literature, preprints, and patents, and provides intuative comparissons to support your research.

Most cited protocols related to «Mucocele»

1
European Guidelines for Pancreatic Cystic Neoplasms
This guideline is a joint initiative of the European Study Group on Cystic Tumours of the Pancreas, the UEG, the EPC, the European-African Hepato-Pancreato-Biliary Association (E-AHPBA), European Digestive Surgery (EDS) and the European Society of Gastrointestinal Endoscopy (ESGE) and involves both European and non-European experts (online supplementary appendix 1).
A methodology committee (gastroenterologists, surgeons, radiologists, oncologists, endoscopists, basic scientists) identified the nine most important topics: biomarkers, radiology, endoscopy, intraductal papillary mucinous neoplasm (IPMN), mucinous cystic neoplasm (MCN), serous cystic neoplasm (SCN), rare cysts and (neo)adjuvant treatment and pathology. Next, multidisciplinary expert groups were formed and each assigned to one topic. In March 2016, each expert group received a list of questions about their topic. The groups could suggest changes and add relevant questions based on their expertise and available literature. Once all questions were finalised, the following steps were taken: (a) a systematic literature search was performed in the PubMed, Embase and Cochrane databases, and the systematic review included randomised or observational cohort studies with a minimum of 20 patients or systematic reviews on PCN, which were published in English, and available in full text; (b) based on the literature review, recommendations were formulated including a GRADE rating for the quality of the evidence and the strength of the recommendation10–12 (link); (c) relevant remarks concerning the recommendations—for instance, about subgroups or availability of diagnostic/therapeutic strategies, were included; (d) a table of relevant studies was provided. The results of these evidence-based recommendations were presented and discussed at a plenary meeting of the European Study Group on Cystic Tumours of the Pancreas in October 2016 during the UEG week.
In January 2017, each expert group submitted the modified version of their task to the methodology committee. A synthesis of the work from different groups was completed in April 2017 (MDC and MGB) and this document was circulated and approved by all the group leaders. Finally, in October 2017, the final recommendations were discussed at a plenary meeting of the European Study Group on Cystic Tumours of the Pancreas during the UEG week. Thereafter, in November 2017, all members of the expert groups were surveyed and asked about their agreement with the final recommendations on a five-point scale (ie, definitely agree, moderately agree, neutral, moderately disagree, definitely disagree) via an anonymous web-based vote. Recommendations with at least 75% consensus (combining ‘definitely’ and ‘moderately’ agree) were accepted as ‘strong agreement’; otherwise ‘weak agreement’ was listed. The results of this survey were added to the evidence-based recommendation in order to provide readers with more insight into the level of agreement among experts. In December 2017, the members of the methodology committee and the group leaders approved the final draft.
Each statement includes the grade of evidence, strength of the recommendation, voting result and, where appropriate, remarks.
European evidence-based guidelines on pancreatic cystic neoplasms. (2018). Gut, 67(5), 789-804.
Publication 2018
Anabolism Biological Markers Committee Members Cyst Debility Diagnosis Digestive System Surgical Procedures Endoscopy, Gastrointestinal Europeans Gastroenterologist Joints Mucins Mucocele Negroid Races Neoplasms Neoplasms, Cystic Neoplasms, Mucinous Oncologists Pancreatic Cyst Patients Pharmaceutical Adjuvants Radiologist Serous Neoplasms Serum Surgeons Therapeutics X-Rays, Diagnostic
2
Pancreatic Ductal Adenocarcinoma Transcriptomics
Level 3 RSEM RNA-sequence data was downloaded from TCGA Data Portal and log2-transformed. Out of 185 participants in the pancreatic cancer TCGA project (PAAD), 183 cases have both OS and RNA-sequence mRNA expression data. Of these 183, 150 cases were registered as “pancreas-adenocarcinoma ductal type” in the histological type section which we analyzed as the PDAC cohort. The remaining 33 cases were registered as “pancreas-adenocarcinoma-other subtype”, “pancreas-colloid (mucinous non-cystic) carcinoma”, “pancreas-colloid (mucinous non-cystic) carcinoma” or “pancreas-neuroendocrine tumor”, which we analyzed as other types of malignancies. As a validation cohort, we obtained paired CD31 gene expression and survival profiles of 63 PDAC samples from the National Cancer for Biotechnology Information GEO database (accession codes GSE57495)9 (link).
Katsuta E., Qi Q., Peng X., Hochwald S.N., Yan L, & Takabe K. (2019). Pancreatic adenocarcinomas with mature blood vessels have better overall survival. Scientific Reports, 9, 1310.
Publication 2019
Adenocarcinoma Anophthalmia with pulmonary hypoplasia Carcinoma Colloids Gene Expression Malignant Neoplasms Mucocele Neuroendocrine Tumors Neurosecretory Systems Pancreas Pancreatic Carcinoma Pancreatic Neoplasm RNA, Messenger Transcription, Genetic
3
Oropharyngeal SCC Histological Classification
Cases of oropharyngeal SCC were identified from a Radiation Oncology head and neck database at Barnes-Jewish Hospital from 1997 to 2004. This is an IRB approved combined retrospective/prospective database with a waiver for retrospective data collection and patient consent for prospective data collection. Radiation was either postoperative for patients managed with an up front surgical approach, or definitive for patients managed without surgery. Patients were treated exclusively with intensity modulated radiation therapy (IMRT) by a single radiation oncologist (WLT). Patients had a minimum of 2 years of clinical follow-up assessed from the end of radiation therapy with the exception of 5 patients who were lost to follow up within 2 years. The mean length of follow-up was 3.3 years (range of 5 months to 8 years). Only cases with primary and pre-treatment surgical pathology material available for review were included. The diagnosis of SCC was confirmed by slide review and all recognized variants such as verrucous, spindle cell, papillary, adenosquamous, undifferentiated, and basaloid squamous cell carcinomas were excluded. Particular care was taken to exclude cases of basaloid squamous cell carcinoma, which is histologically distinct from nonkeratinizing squamous cell carcinoma. Basaloid squamous cell carcinoma, as defined by Wain’s criteria, is intimately associated with keratinizing squamous cell carcinoma, and is composed of a lobular proliferation of small, crowded cells with scant cytoplasm and round, hyperchromatic nuclei [24 (link)]. In addition, it has cystic spaces with mucin-like material, coagulative necrosis and stromal hyalinosis with basement membrane-like material [22 (link)].
The cases were classified independently by three reviewers (RDC, SKEM, JSL), prior to HPV testing and without knowledge of clinical outcome, into the following three categories based upon histologic features: NK SCC, K SCC, and those with overlapping features (referred to as hybrid SCC). NK SCC was defined as forming sheets, nests or trabeculae with pushing borders, little stromal response, and having ovoid to spindled, hyperchromatic cells that lack prominent nucleoli and have indistinct cell borders (Fig. 1). Comedo-type necrosis and brisk mitotic activity were often present but were not considered requisite features. While varying from well to poorly differentiated, K SCC was defined as entirely composed of mature squamous cells without areas with NK SCC morphology (Fig. 2). Hybrid SCC showed nonkeratinizing morphology but with areas of squamous maturation (Fig. 3). Discrepant cases were collectively arbitrated around a multi-headed microscope by all three study pathologists and placed in a single category.
Chernock R.D., El-Mofty S.K., Thorstad W.L., Parvin C.A, & Lewis JS J.r. (2009). HPV-Related Nonkeratinizing Squamous Cell Carcinoma of the Oropharynx: Utility of Microscopic Features in Predicting Patient Outcome. Head and Neck Pathology, 3(3), 186-194.
Publication 2009
Cancellous Bone Cell Nucleolus Cell Nucleus Cell Proliferation Cells Coagulation, Blood Cytoplasm Diagnosis Hybrids Membrane, Basement Microscopy Mucocele Neck Necrosis Operative Surgical Procedures Oropharynxs Pathologists Patients Radiation Oncologists Radiotherapy Radiotherapy, Intensity-Modulated Squamous Cell Carcinoma Squamous Epithelial Cells
4
Comparison of IPMN-Associated and Standard Pancreatic Adenocarcinoma
From 1995 to 2006, 312 consecutive patients underwent pancreatectomy at Johns Hopkins Hospital for an IPMN. Of those, 132 (42%) were identified to have an invasive adenocarcinoma arising in the setting of their IPMN. These patients were compared with 1128 consecutive patients with standard pancreatic ductal adenocarcinoma who underwent pancreatic resection at our institution during the same period. All patients underwent pancreatectomy with curative intent. We elected to restrict this comparison to patients operated upon in or after the year 1995, as this is when a pathologic evaluation template for pancreatic resection specimens was implemented at our institution, including systematic evaluation and reporting of T stage, nodal metastasis, resection margins, grade, vascular, and perineural invasion for all pancreatectomy specimens. T stage in all lesions was defined based on size/local extension of only the invasive component of the IPMN. The noninvasive component was not included. Microscopic margin involvement (R1 resection) was defined as margin involvement by invasive carcinoma for both IPMN-associated and standard pancreatic adenocarcinoma. Specifically, for IPMN-associated cancers, margin involved by noninvasive mucinous epithelium with or without dysplasia was considered as negative (R0 resection) for the purposes of this analysis, to assure an equal comparison between the 2 groups.
IPMN was defined as mucin-producing cystic neoplasm with tall, columnar epithelium, with or without papillary proliferations that extensively involved the main pancreatic duct or side branches.14 (link) IPMN was distinguished from mucinous cystic neoplasms, which were characterized by the presence of “ovarian-type” stroma, and the lack of communication with the pancreatic ductal system. As opposed to pancreatic intraepithelial neoplasia (PanIN), to be classified as an IPMN the lesion had to be grossly and/or radiographically visible. IPMN-associated invasive adenocarcinomas were classified into 3 histopathologic types: tubular, if they resembled conventional infiltrating ductal adenocarcinomas with predominantly tubular neoplastic glands associated with a desmoplastic stroma in the absence of significant stromal mucin (Fig. 1A); colloid, if they consisted of extensive (>80%) stromal pools of extracellular mucin, containing relatively scant strips, clusters, or individual neoplastic cells, sometimes with a signet ring cell appearance (Fig. 1B)10 (link); and anaplastic (undifferentiated). Margins of resection (pancreatic neck, uncinate process, bile duct, and duodenum or stomach for pancreaticoduodenectomy specimens; pancreatic transection margin and retroperitoneum for distal pancreatectomy specimens) were examined and scored based on the highest degree of dysplasia present. Dysplasia was graded as low, moderate, or high (carcinoma in situ).
Data were obtained through retrospective review of a prospectively maintained pancreatic resection database, electronic hospital charts, and outside medical records. Continuous variables are presented as median (range) and compared using the Wilcoxon rank sum test. Categorical variables are presented as absolute number (percentage) and compared using the χ2 and Fisher exact test tests, as appropriate. Survival probabilities were computed using the Kaplan-Meier method and compared using the log-rank test. A multivariate model was performed using proportional hazards regression, to identify factors independently associated with survival after resection. Survival analysis excluded patients who died in the 30-day postoperative period. Cause of death was not available for all patients so only overall survival was calculated.
Poultsides G.A., Reddy S., Cameron J.L., Hruban R.H., Pawlik T.M., Ahuja N., Jain A., Edil B.H., Iacobuzio-Donahue C.A., Schulick R.D, & Wolfgang C.L. (2010). Histopathologic Basis for the Favorable Survival after Resection of Intraductal Papillary Mucinous Neoplasm-Associated Invasive Adenocarcinoma of the Pancreas. Annals of surgery, 251(3), 470-476.
Publication 2010
Adenocarcinoma Adenocarcinoma, Tubular Anaplasia Blood Vessel Carcinoma Carcinoma, Pancreatic Ductal Carcinoma in Situ Cells Colloids Cyst Duct, Bile Duct, Main Pancreatic Duodenum Epithelium Fibrosis Glandular Neoplasms Malignant Neoplasms Microscopy Mucins Mucocele Neck Neoplasm Metastasis Neoplasms Neoplasms, Cystic Neoplasms, Mucinous Ovary Pancreas Pancreatectomy Pancreatic Duct Pancreatic Neoplasm Pancreaticoduodenectomy Patients Precursor T-Cell Lymphoblastic Leukemia-Lymphoma Retroperitoneal Space Stomach Surgical Margins
5
Laparoscopic Cholecystectomy: Standardizing Operative Complexity
A prospective study of consecutive laparoscopic cholecystectomies performed between January 2016 and December 2019 was conducted to specifically assess issues relating to the CVS and the feasibility of displaying it during every LC. This cohort represents the last 5th of the senior surgeon’s experience of 5675 LC over 28 years. This firm is a referral unit subspecialising in biliary emergencies for over 25 years and as such, it deals with a significant percentage of complex cases. No ethical approval was necessary as this was a clinical study using a standard protocol for LC. The procedures were performed by the senior author or by his trainees under direct on table supervision. Data on patient demographics, type of admission, clinical presentation, radiological findings, interval from admission to surgery, operative difficulty grade, achievement of CVS, operative time, conversion to open, perioperative complications, re-admissions and mortality were recorded. The operative difficulty grade was based on the Nassar Scale [11 (link)] (Table 1). This scale was validated as a tool of reporting operative findings and technical difficulty in 2 different large datasets including the CholeS study and found to standardise the description of operative findings by multiple grades of surgeons in over 8800 cases [12 (link)].

Operative difficulty grading: modified nassar scale

GradeDescription
IGallbladder—floppy, non-adherent
Cystic pedicle—thin and clear
Adhesions—simple up to the neck/Hartmann's pouch
IIGallbladder—mucocele, packed with stones
Cystic pedicle—fat laden
Adhesions—simple up to the body
IIIGallbladder—deep fossa, acute cholecystitis, contracted, fibrosis, Hartmann’s adherent to CBD, impaction
Cystic pedicle—abnormal anatomy or cystic duct—short, dilated or obscured
Adhesions—dense up to fundus; involving hepatic flexure or duodenum
IVGallbladder—completely obscured, empyema, gangrene, mass
Cystic pedicle—impossible to clarify
Adhesions—dense, fibrosis, wrapping the gallbladder, duodenum or hepatic flexure difficult to separate
VMirizzi Syndrome type 2 or higher, cholecysto-cutaneous, cholecysto-duodenal or cholecysto-colic fistula
This biliary firm managed, by protocol, most referrals of biliary emergencies within the hospital and occasionally inter-hospital transfers. An emergency workload of 60% is agreed according to the senior surgeon’s job plan. The unit adopts single session laparoscopic management of bile duct stones. Endoscopic Retrograde Cholangiopancreatography (ERCP) is not relied upon for preoperative clearance of choledocholithiasis and it is only used in patients unfit for general anaesthesia.
Informed consent was obtained from all patients with specific emphasis on the specialisation of the unit with regard to the management of suspected bile duct stones. IRB approval was not required as the management protocols were consistent with the recommendations of national and international societies.
Nassar A.H., Ng H.J., Wysocki A.P., Khan K.S, & Gil I.C. (2020). Achieving the critical view of safety in the difficult laparoscopic cholecystectomy: a prospective study of predictors of failure. Surgical Endoscopy, 35(11), 6039-6047.
Publication 2020
Acute Cholecystitis Bile Calculi Cholecystectomy, Laparoscopic Choledocholithiasis Colic Flexure, Right Duct, Bile Ducts, Cystic Duodenum Emergencies Empyema Endoscopic Retrograde Cholangiopancreatography Fibrosis Gallbladder Gangrene General Anesthesia Laparoscopy Mucocele Neck Operative Surgical Procedures Patients Skin Supervision Surgeons Syndrome X-Rays, Diagnostic

Most recents protocols related to «Mucocele»

1
Distal Interphalangeal Arthrodesis with Screw Fixation
This was a retrospective chart review of all DIP arthrodesis procedures performed at our institution between November 2018 and November 2021. Inclusion criteria included patients aged 18 years or older who had undergone elective, clean, DIP arthrodesis with intramedullary screw fixation, and documentation of whether antibiotic prophylaxis was administered. Patients who underwent DIP arthrodesis due to acute injury, revision procedures, or DIP procedures with any concurrent procedures other than mucous cyst excision were excluded. The inclusion and exclusion criteria are listed. (See table, Supplemental Digital Content 1, which displays the full inclusion and exclusion criteria. DIP indicates distal interphalangeal. http://links.lww.com/PRSGO/C439.)
The following data were collected for each patient: age, sex, race, smoking status, diabetes mellitus status, preoperative antibiotic administration, anesthesia used, duration of the procedure, postoperative infections, and any treatment to address postoperative infection if it occurred. All the procedures were performed in an operating room with full sterility. Procedure was performed with a dorsal incision, and the bone was prepared using either a rongeur or high-speed bur. A pin was placed antegrade from arthrodesis site out the tip of the finger and then retrograde down the shaft of the middle phalanx to the base. A stab incision was made in the fingertip, and the cannulated drill was then placed from the fingertip across the distal phalanx into the diaphysis of the middle phalanx; the screw was then placed over the wire. All screws used in these procedures were either Accutrak 2 headless compression screw by Acumed or the REDUCT headless compression screw by Skeletal Dynamics. No procedures were performed in an in-office procedure room, and no procedures were performed with field sterility. Patients who received antibiotics prophylactically were administered either intravenous cefazolin or clindamycin. The sequence of events for the patients in our study was injection of lidocaine as a local anesthetic, administration of antibiotics if ordered by the surgeon, preparation and draping, application of a finger tourniquet if epinephrine was not used, and incision.
Vohra S.F., Beck J.H., Barrett P.C., Bravo C.J, & Apel P.J. (2023). Antibiotic Prophylaxis for Distal Interphalangeal Joint Arthrodesis. Plastic and Reconstructive Surgery Global Open, 11(3), e4848.
Publication 2023
Anesthesia Antibiotic Prophylaxis Antibiotics Antibiotics, Antitubercular Arthrodesis Bones Bones of Fingers Cefazolin Clindamycin Diabetes Mellitus Diaphyses Drill Epinephrine Fingers Infection Injuries Lidocaine Local Anesthesia Mucocele Patients Skeleton Sterility, Reproductive Surgeons Thumb Tourniquets
2
Survival Outcomes in Stage IB Gastric Cancer
Population-based information was retrieved from the SEER program. The inclusion criteria were as follows: (1) age older than 18 years; (2) pathologic confirmation was adenocarcinoma, mucinous adenocarcinoma, mucin-producing adenocarcinoma, mucinous cyst-adenocarcinoma, signet ring cell carcinoma, papillary adenocarcinoma, tubular adenocarcinoma, adenocarcinoma intestinal type, carcinoma diffuse type, adenocarcinoma with mixed subtype; (3) patients who received radical operation; (4) the sixth edition AJCC stage was IB (T1N1M0 or T2aN0M0).
The exclusion criteria were as follows: (1) patients who only lived for a month or less; (2) regional positive lymph nodes were 3, 4, 5, and 6 among T1N1 (1–6 positive nodes) M0 patients because all these data were translated to conform the eighth edition of the AJCC system to get a sufficient follow-up time; (3) Patients with incomplete demographic, clinicopathological, therapy or follow-up data were eliminated from the study. In the end, 1889 patients were enrolled in the research. The process of patient selection is presented in Fig. 1.

The workflow of the patient selection process

Xie Y., Song X., Du D., Jin H., Li X., Ni Z, & Huang H. (2023). A novel nomogram for identifying candidates for adjuvant chemotherapy in patients with stage IB gastric adenocarcinoma. BMC Gastroenterology, 23, 54.
Publication 2023
Adenocarcinoma Adenocarcinoma, Tubular Carcinoma Carcinoma, Signet Ring Cell Cyst Intestines Mucinous Adenocarcinoma Mucocele Nodes, Lymph Papillary Adenocarcinoma Patients Therapeutics
3
Retrospective Study of Pancreatic Resections
This retrospective descriptive study analyzed all the patients who underwent an upfront pancreatic resection at the Department of Surgery of the Elisabethinen Hospital (Linz, Austria) between January 2000 and December 2019. The following inclusion criteria were defined (Figure 1): age ≥ 18 years; preoperative clinical and/or radiologic suspicion of pancreatic or periampullary solid malignancy, and pNET. Exclusion criteria included: patients with a conclusive preoperative histology; patients with suspicion (or cyto-/histological diagnosis) of intraductal papillary mucinous neoplasia (IPMN), mucinous cystic neoplasia (MCN), serous cystic neoplasia (SCN), CP, other rare malignancies or metastases involving the hepato-pancreato-biliary district (e.g., melanoma, renal cell carcinoma, sarcoma, etc.). Furthermore, those patients who underwent pancreatic resections after chemo- or radiotherapy (secondary resection) were excluded.
All data were obtained from the prospectively maintained patient registry of the Department of Surgery. The pre- and postoperative clinical history of patients, as well as the most relevant demographic and clinical data were additionally checked and proofed through the review of the outpatient clinic reports, discharge letters, radiologic and operative reports. Additionally, in case of discrepancies between preoperative clinical suspicion and pathology report (see the section Outcomes, definition of “mismatch”) the clinical history and the available cross-sectional images (computer tomography and/or magnetic resonance) were independently reviewed from two surgeons (R.F. and N.S.) in order to identify eventual diagnostic mistakes and to assess the appropriateness of the whole diagnostic process. If required—i.e., when the reviewers’ judgements did not match each other—the cases were discussed with the other co-authors until a final shared assessment was reached.
This study was approved by the institutional Ethics Committee (Ordensklinikum Linz, EK 1225/2019) and was performed in compliance with the Good Clinical Practice standard and the principles of the Declaration of Helsinki.
Surci N., Rösch C.S., Kirchweger P., Havranek L., von Boetticher P., Fischer I., Wundsam H.V., Biebl M, & Függer R. (2023). The Rate of Avoidable Pancreatic Resections at a High-Volume Center: An Internal Quality Control and Critical Review. Journal of Clinical Medicine, 12(4), 1625.
Publication 2023
Cyst Diagnosis Institutional Ethics Committees Magnetic Resonance Imaging Malignant Neoplasms Melanoma Mucins Mucocele Neoplasms Neoplasms, Cystic Neoplasms, Mucinous Operative Surgical Procedures Pancreas Pancreatectomy Patient Discharge Patients Radiotherapy Renal Cell Carcinoma Sarcoma Serous Neoplasms Serum Surgeons Tomography
4
Quantitative Analysis of Apical Mucin Secretion
Apical mucin secretion was analyzed semi-quantitatively. For each 3D model, three different randomly chosen cross sections were evaluated by estimating the amount of immunofluorescence signals of Muc5AC and Muc5B, respectively, per total surface of a cross section. Scoring was: zero points (no detection), one point (sporadic detection on the surface), two points (<50% of the surface), three points (>50% of the surface). (For Muc5B: six models each medium; for Muc5AC: six models with AECG medium, five models for PC ALI medium, all from four donors). The presence of intraepithelial mucus cysts was analyzed using the same cross sections, which were used for the mucin score. Immunofluorescence signals of Muc5AC and Muc5B within the epithelial layer in DAPI-free areas were counted as presence of intraepithelial mucus cysts. Given is the percentage of cross sections on which intraepithelial immunofluorescence signals of either Muc5AC or Muc5B were detected.
Maurer J., Walles T, & Wiese-Rischke C. (2023). Optimization of Primary Human Bronchial Epithelial 3D Cell Culture with Donor-Matched Fibroblasts and Comparison of Two Different Culture Media. International Journal of Molecular Sciences, 24(4), 4113.
Publication 2023
DAPI Donors Immunofluorescence MUC5AC protein, human MUC5B protein, human Mucins Mucocele secretion
5
Cytological Examination of Canine Bile
Bile samples collected from control dogs underwent cytological examination by an American College of Veterinary Pathology certified study investigator (D.S.). Each cytological specimen was prepared at the time of bile collection by smearing a drop of bile onto each of 2 individual glass microscope slides. Slides were air-dried, fixed, and stained with hematoxylin and eosin. Samples of gallbladder mucus from dogs with mucocele formation were not examined cytologically.
Gookin J.L., Hartley A.N., Aicher K.M., Mathews K.G., Cullen R., Cullen J.M., Callahan B.J., Stowe D.M., Seiler G.S., Jacob M.E., Arnold J.W., Azcarate-Peril M.A, & Stauffer S.H. (2023). Gallbladder microbiota in healthy dogs and dogs with mucocele formation. PLOS ONE, 18(2), e0281432.
Publication 2023
Bile Canis familiaris Eosin Gallbladder Microscopy Mucocele Mucus

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