Journal of Advanced Clinical & Research Insights (2018), 5, 207–209 Journal of Advanced Clinical & Research Insights ● Vol. 5:6 ● Nov-Dec 2018 207 CASE REPORT An atypical manifestation of mucocele - A case report Tejavathi Nagaraj, Arundhati Biswas, Swati Saxena, Poonam Sahu Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences, Bengaluru, Karnataka, India Abstract Mucocele is a painless benign swelling in the oral cavity caused by a blockage of salivary gland or its duct. Although they are painless but may cause difculty to patients for eating and speaking. Most mucoceles are visually identifable. Only a few of mucoceles do not require any special treatment, and most of them can be removed by surgical excision� Mucoceles most commonly afect young patients. Usually, extravasation mucoceles are located in the lower lip and retention mucoceles can be seen at any site in the oral cavity� Trauma is the main causative factor involved in the formation of mucoceles� It is essential to visually recognize mucocele, for its proper treatment� This article reports a case of mucocele in a patient with sudden trauma on the lower lip� It was clinically diagnosed as traumatic fbroma because of its atypical presentation which was treated by surgical excision� Keywords: Benign lesion, extravasation mucocele, traumatic fbroma Correspondence: Dr. Arundhati Biswas, Department of Oral Medicine and Radiology, Sri Rajiv Gandhi College of Dental Sciences, Bengaluru -560 032, Karnataka, India. Phone: 9845451029. E-mail: arundhatibds@gmail.com Received: 05 October 2018; Accepted: 25 November 2018 doi: 10.15713/ins.jcri.246 Introduction Mucocele develops following retention or extravasation of mucous in the subepithelial connective tissue from the salivary gland and duct� [1] Mucocele is a benign lesion of the oral cavity that0commonly results from a change in the minor salivary glands because of collection of mucous causing a swelling or growth� [2] They appear as non-tender, bluish, fuctuant submucosal swelling, or growth with overlying mucosa being normal� Mucocele is of two types, extravasation and retention� Retention mucocele occurs due to mucus retained in the duct and/or acini as a result of duct obstruction� [3,4] Extravasation mucocele occurs due to tear in the salivary gland duct and which results in the spillage of mucous into the subepithelial connective tissue around the gland� [5] Clinically, it is difcult distinguishing between extravasation and retention type of mucocele. Mucocele in the foor of the mouth is called as a “ranula” because of its appearance as “frogs belly�” Superfcial or classical mucocele does not have epithelial lining. Location of superfcial mucocele is under the mucous membrane. Classical mucocele is shown in the upper submucosa� [3,6] Case Report A male patient aged 21 years reported to the department of oral medicine and radiology with the chief complaint of growth on the left lower lip due to sudden trauma 1 day back due to lip biting� Medical history was non-contributory� The patient was moderately built and nourished. Extraoral examination revealed no facial asymmetry� Intraoral examination revealed a solitary growth on the lower left labial mucosa measuring about 0�5 cm in diameter round in shape having a pedunculated base [Figure 1]� The surface over the growth appears smooth shiny and erythematous� Palpation of the growth confrms all inspectory fndings. The growth was frm in consistency, non-fuctuant, non-reducible, and non-tender. On relating the clinical history with the examination, a provisional diagnosis of traumatic fbroma of the lower left labial mucosa with the diferential diagnosis of pyogenic granuloma, mucocele, and lipoma was made. Excisional biopsy was advised [Figures 2 and 3]. The excised lesion was sent for histopathological examination which revealed soft tissue devoid of epithelium� Fibrovascular connective tissue stroma shows granulation areas with chronic infammatory infltrate consisting of lymphocytes, plasma cell, and mucinophages� Mucin spillage and pooling are shown with endothelial lined blood vessels surrounded by fbrous septa, suggestive of “extravasation type of mucocele�” On the basis of histopathological report and clinical fndings, a fnal diagnosis of extravasation mucocele of lower left labial mucosa was made� The patient is under follow-up� Discussion Mucocele clinically appears as a slow growing, painless, and fuctuant growth or swelling that occurs due to mucus extravasation or mucous retention from the salivary gland� It is a common benign cystic lesion, ranked 17 th most common salivary gland lesion and the 2 nd of most common soft tissue