Mucocele

BackgroundGallbladder mucoceles (GBM) typically are treated by cholecystectomy. Medical management rarely has been reported and medical and surgical management have not been compared.Hypothesis/objectivesTo compare survival of dogs treated for GBM by medical management or cholecystectomy or both.AnimalsEighty-nine client-owned dogs diagnosed with GBM that received cholecystectomy or medical treatment or both from 2011 to 2017.MethodsPotential cases were identified by searching the medical records database. Data collected included signalment, clinicopathologic results, treatments, and ultrasonographic images and reports. Dogs were grouped according to the treatment received (medical management, surgical treatment, or both) that was chosen at the discretion of the attending veterinarian. Survival analysis was performed and prognostic variables identified and compared between treatment groups.ResultsOf dogs surviving at least 14 days after diagnosis, median survival times were 1802 (95% confidence interval [CI], 855-not reached) days, 1340 (95% CI, 444-1340) days, and 203 (95% CI, 18-525) days, for the surgical, medical, and medical then surgical treatment groups, respectively, and differed significantly (P Conclusions and clinical importanceCholecystectomy for the treatment of GBM results in the best long-term survival in dogs surviving the immediate postoperative period (14 days) compared to medical management. Although medical management is associated with shorter survival compared to surgical treatment, it is a reasonable alternative when surgery cannot be pursued.

BackgroundMucoceles are benign lesions related to the minor salivary glands and their respective ducts frequently affecting oral structures which are generally asymptomatic. Mucoceles are generally characterized by swollen nodular lesions preferentially located on the lower lip and differ from the so-called ranulas, which are lesions located on the floor of the mouth and related to the sublingual or submandibular glands.MethodsThe objective of the present study was to analyze data such as age, gender, race and site of the lesion of 173 mucocele cases diagnosed at the Discipline of Stomatology, São José dos Campos Dental School, UNESP, over a period of 24 years (April 1980 to February 2003).ResultsOf the 173 cases analyzed, 104 (60.12%) were females and 69 (39.88%) were males. Age ranged from 4 to 70 years (mean +/- SD: 17 +/- 9.53) and most patients were in the second decade of life (n = 86, 49.42%); white (n = 124, 71.68%). The lower lip was the site most frequently affected by the lesions (n = 135, 78.03%), whereas the lowest prevalence was observed for the soft palate, buccal mucosa, and lingual frenum.ConclusionIn this study, mucoceles predominated in white female subjects in the second decade of life, with the lower lip being the most frequently affected site.

BackgroundMaxillary sinus mucoceles are relatively rare among all paranasal sinus mucoceles. With the introduction of endoscopic sinus surgical techniques, rhinologic surgeons prefer transnasal endoscopic management of sinus mucoceles. The aim of this study is to describe the clinical presentation of maxillary sinus mucoceles and to establish the efficacy of endoscopic management of sinus mucoceles.MethodsBetween 2003 and 2005, 14 patients underwent endoscopic sinus surgery for maxillary sinus mucocele. The presenting sign and symptoms, radiological findings, surgical management and need for revision surgery were reviewed.ResultsThere were eight males and six females with an age range of 14 to 65. Ten patients complained of nasal obstruction, five of nasal drainage, five of cheek pressure or pain and one of proptosis of the eye and cheek swelling. The maxillary sinus and ipsilateral ethmoid sinus involvement on computed tomographic studies was seen in 4 patients. Four patients had history of endoscopic ethmoidectomy surgery for ethmoid sinusitis and one had Caldwell-Luc operation in the past. Ethmoidectomy with middle meatal antrostomy and marsupialization of the mucocele was performed in all patients. Postoperative follow-up ranged between 8 to 48 months. All patients had a patent middle meatal antrostomy and healthy maxillary sinus mucosa. No patients need revision surgery.ConclusionThe most common causes of mucoceles are chronic infection, allergic sinonasal disease, trauma and previous surgery. In 64% of the patients of our study cause remains uncertain. Endoscopic sinus surgery is an effective treatment for maxillary sinus mucoceles with a favorable long-term outcome.

BackgroundGallbladder disease in people is frequently associated with disorders of lipid metabolism and metabolic syndrome. A recently emergent gallbladder disease of dogs, referred to as mucocele formation, is characterized by secretion of abnormal mucus by the gallbladder epithelium and is similarly associated with hyperlipidemia, endocrinopathy, and metabolic dysfunction. The cause of gallbladder mucocele formation in dogs is unknown.MethodsA prospective case-controlled study was conducted to gain insight into disease pathogenesis by characterization of plasma lipid abnormalities in 18 dogs with gallbladder mucocele formation and 18 age and breed matched control dogs using direct infusion mass spectrometry for complex plasma lipid analysis. This analysis was complemented by histochemical and ultrastructural examination of gallbladder mucosa from dogs with gallbladder mucocele formation and control dogs for evidence of altered lipid homeostasis of the gallbladder epithelium.ResultsGallbladder mucocele formation in dogs carried a unique lipidomic signature of increased lipogenesis impacting 50% of lipid classes, 36% of esterified fatty acid species, and 11% of complex lipid species. Broad enrichment of complex lipids with palmitoleic acid (16:1) and decreased abundance within complex lipids of presumptive omega-3 fatty acids eicosapentaenoic (20:5) and docosahexaenoic (22:6) was significant. Severe lipidosis of gallbladder epithelium pinpoints the gallbladder as involved causally or consequently in abnormal lipid metabolism.ConclusionOur study supports a primary increase in lipogenesis in dogs with mucocele formation and abnormal gallbladder lipid metabolism in disease pathogenesis.