Mucocele of lower lip — ORE Part 1 MCQ

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EasyOral Medicine and Oral PathologyMucocele of lower lipORE Part 1

A 16-year-old patient has a recurrent bluish, fluctuant swelling on the lower labial mucosa that enlarges after accidental biting and sometimes ruptures. It is painless and not attached to bone. The adjacent teeth are sound. What is the most likely diagnosis?

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Correct answer: C — Mucocele

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

The correct answer is A (Mucocele). The clinical presentation is pathognomonic for mucocele: lower lip location (most common site, 78–80% of cases), bluish fluctuant appearance, painlessness, mobile consistency, trauma history (biting), spontaneous rupture with recurrence, and non-attachment to underlying bone. Mucoceles arise from extravasation of saliva from minor salivary gland ducts following trauma. Differential diagnosis: Fibroepithelial polyp (B) is hard, sessile, and similar in colour to mucosa—not bluish or fluctuant. Minor aphthous ulcer (C) is painful, erythematous, and ulcerated, not a fluid-filled fluctuant swelling. Ranula (D) is a mucocele of the floor of mouth/sublingual gland, located in the floor of mouth or ventral tongue, not the lower labial mucosa. Squamous papilloma (E) is an epithelial growth, firm and non-fluctuant, not bluish. The site (lower labial), texture (fluctuant), colour (bluish), trauma history, and recurrent rupture are diagnostic.

Reference: Ayoub M, Ghosein E. Management of a Recurrent Lower Lip Mucocele in a Pediatric Patient: A Case Report. Cureus. 2025. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12754822/ and Neville BW, Damm DD, Allen CM, et al. Oral and Maxillofacial Pathology. 4th ed. Elsevier; 2016 (standard oral pathology reference, internationally recognized).