Mucocoele — ORE Part 1 MCQ

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EasyOral PathologyMucocoeleORE Part 1

A 25-year-old woman presents with a dome-shaped bluish translucent swelling on her lower lip. It is fluctuant and approximately 8 mm in diameter. She reports it has been present for 3 months and occasionally ruptures, releasing a viscous fluid, before reforming. What is the most likely diagnosis?

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Correct answer: C — Mucocoele

Explanation lettering: B = shown as A · D = shown as B · A = shown as C · C = shown as D

The correct answer is A – Mucocoele. The clinical presentation is pathognomonic: a dome-shaped, bluish translucent, fluctuant lesion on the lower lip with recurrent rupture, viscous fluid discharge, and reformation. These features reflect a benign pseudocyst formed by extravasation of mucus from a traumatised minor salivary gland duct. Mucocoele is the most common oral mucosal lesion and typically affects young adults, with the lower lip as the most frequent site. Diagnosis is clinical; the natural history of bursting and refilling is characteristic. Pleomorphic adenoma (B) is a salivary gland tumour, typically firmer, non-translucent, and does not rupture spontaneously. Fibroma (C) is a fibroblastic lesion that is not fluctuant and does not discharge fluid. Haemangioma (D), though bluish, is vascular in origin and does not present with mucus release or cyclic rupture–reformation. Minor salivary gland tumour (E) is too non-specific; the clinical features point definitively to mucocoele rather than neoplasia.

Reference: Oral mucocele: Review of literature and a case report. PubMed 2015. https://pubmed.ncbi.nlm.nih.gov/26538955/