코눈물관을 침범한 코곁굴 점액낭종에서 코경유눈물주머니코안연결술의 효과

정규철,조승환,양재욱 대한안과학회 2018 대한안과학회지 Vol.59 No.3

Purpose: To evaluate the effect of endonasal dacryocystorhinostomy in the paranasal mucocele invading nasolacrimal duct. Methods: We analyzed 252 patients who were diagnosed with paranasal mucocele from 2006 to 2017, and found 14 patients (14 eyes) who underwent endonasal dacryocystorhinostomy in the paranasal mucocele invading nasolacrimal duct. Clinical features and surgical results of the patients were analyzed retrospectively. Results: The origins of the mucocele were frontoethmoidal sinus (seven cases, 50%) and ethmoidal sinus(seven cases, 50%). The most common symptom from the first visit was epiphora (13 cases, 92.8%); medial canthal mass (nine cases, 64.2%) was the second most common symptom. Every patient underwent endonasal dacryocystorhinostomy with rhinology and sinus surgery according to the type, size, and severity of the paranasal mucocele. Every patient showed successful irrigation in the lacrimal canalicular irrigation test and improved epiphora 6 months postoperatively. Conclusions: When paranasal mucocele invades the orbit, it can cause diplopia, exophthalmos, extraocular muscle movement disorders, visual impairments, and increased intraocular pressure. Furthermore, if it invades the nasolacrimal duct, it can cause obstruction of the nasolacrimal duct and result in epiphora. Based on our results, endonasal dacryocystorhinostomy was an effective primary treatment. 목적: 코눈물관을 침범한 코곁굴 점액낭종에서 코경유눈물주머니코안연결술을 시행하였고, 그 효과를 알아보고자 하였다. 대상과 방법: 2006년부터 2017년까지의 의무기록을 열람하여, 코곁굴 점액낭종으로 진단된 환자 252명 중, 코눈물관을 침범해 코경유눈물주머니코안연결술을 시행한 14명(14안)을 대상으로, 그 임상적 특징 및 수술 결과를 후향적으로 분석하였다. 결과: 점액낭종의 기원은 전두사골동 7예(50%), 사골동 7예(50%)로 나타났다. 초진 당시 호소했던 증상 중 가장 흔한 증상은 눈물흘림이었으며(13예, 92.8%), 내안각 종괴(9예, 64.2%)가 두 번째로 흔한 증상이었다. 초진 시 모든 환자의 눈물소관 관류검사에서 코눈물관폐쇄 소견으로 나타났고, 안압이 상승된 경우는 2예(14.3%)에서 발견되었다. 모든 대상 환자에서 안과에서는 코경유눈물주머니코안연결술을 시행하였고, 이비인후과에서는 점액낭종의 종류 및 크기, 심한 정도에 따라 수술을 동시에 시행하였다. 술 후 6개월 뒤, 눈물흘림 증상이 있던 모든 환자에서 눈물흘림 증상은 호전되었고, 모든 환자에서 눈물소관 관류검사 시 성공적인 관류 소견을 보였다. 결론: 점액낭종이 안와에 침범할 경우 복시, 안구돌출, 안구운동장애, 시력 장애, 안압 상승 등을 유발할 수 있다. 나아가 코눈물관을 침범할 경우 코눈물관폐쇄를 유발하여 환자에게 눈물흘림을 유발할 수 있다. 이 경우 점액낭종 조대술과 동시에 시행하는 코경유눈물주머니코안연결술이 효과적인 일차적 치료법으로 판단된다.

우연히 발견된 충수돌기 점액종류 1예

권성일,김규종,이지영,김동완,노치환,박무인,박선자,구자영,백승언 고신대학교 의학부 2000 高神大學校 醫學部 論文集 Vol.15 No.1

Mucocele of the appendix is an uncommon disorder which is rarely diagnosed prior to a laparotomy. With progress in diagnostic procedures, such as the use of colonoscopy, ultrasonography, and computed tomography, preoperative diagnosis of the appendiceal mucocele has become possible. There have been several reported cases of appendiceal mucocele in which various symptoms and signs were present. In this case, a 50-year old female patient visited our hospital because of constipation and rectal bleeding, and then she had an incidental finding of mucocele of the appendix during colonoscopic evaluation for constipation and rectal bleeding. We have experienced the case of preoperatively diagnosed appendiceal mucocele by a colonoscopy and abdominal CT and barium enema in which she was operated and the surgical specimen revealed appendiceal mucocele.

Mucocele in the maxillary sinus involving the orbit: A report of 2 cases

Yeom, Han-Gyeol,Lee, Wan,Han, Su-Il,Lee, Jae-Hoon,Lee, Byung-Do Korean Academy of Oral and Maxillofacial Radiology 2022 Imaging Science in Dentistry Vol.52 No.-

Mucocele of the paranasal sinuses is a benign, slow-growing, expansile lesion. Maxillary sinus mucoceles are usually associated with painless bulging of the cheek; however, orbital expansion is rarely observed. Maxillary sinus mucoceles can be classified as primary or secondary according to their etiology. An impediment to sinus ostium ventilation is thought to be the cause of primary mucocele, while sequestering of residual mucosa after surgery in the wound and long-term retention of tissue fluid have been suggested to lead to the formation of secondary mucocele. This report presents 2 cases of primary and secondary mucoceles, with a focus on radiographic features. As primary and superiorly positioned secondary maxillary sinus mucoceles are uncommon and their close proximity to the orbit predisposes the patient to significant morbidity, the authors expect that this report will contribute to a better understanding and diagnosis of maxillary sinus mucocele involving the orbit.

Mucocele mistaken for epidermal cyst

( Do Hyeon Kim ),( Bora Lim ),( Chil Hwan Oh ),( Kun Park ) 대한피부과학회 2019 대한피부과학회 학술발표대회집 Vol.71 No.1

Cystic lesions of oral, facial and neck soft tissues have been defined, described and studied in numerous studies. Cysts of the soft tissues are in general recognized by their clinical appearance, site and symptoms. A 67-year-old man presented with asymptomatic cystic mass on right cheek. The lesion developed 3 years ago and size slightly increased. However there are no symptoms in the oral cavity. The patient had no medication history. We performed excision with suspicion of epidermal cyst. On the histopathological examination, the lesion was diagnosed as mucocele. Mucocele is most common minor salivary gland lesion. Minor salivary glands are found in most parts of the oral cavity except the gingiva. Clinically they are characterized by single or multiple, soft, fluctuant nodule. The development of mucoceles depend on the disruption of the flow of saliva from the secretory apparatus of the salivary glands. Therefore, most mucocele occur in the oral cavity and have intraoral symptoms. However, our case showed only cutaneous symptom. For treatment mucocele, surgical excision of the mucocele along with the adjacent associated minor salivary glands is recommended.Herein, We report a rare case of mucocle on face that was mistaken for epidermal cyst.

Mucocele in the maxillary sinus involving the orbit: A report of 2 cases

Yeom Han-Gyeol,Lee Wan,Han Su-Il,Lee Jae-Hoon,이병도 대한영상치의학회 2022 Imaging Science in Dentistry Vol.52 No.3

Mucocele of the paranasal sinuses is a benign, slow-growing, expansile lesion. Maxillary sinus mucoceles are usually associated with painless bulging of the cheek; however, orbital expansion is rarely observed. Maxillary sinus mucoceles can be classified as primary or secondary according to their etiology. An impediment to sinus ostium ventilation is thought to be the cause of primary mucocele, while sequestering of residual mucosa after surgery in the wound and long-term retention of tissue fluid have been suggested to lead to the formation of secondary mucocele. This report presents 2 cases of primary and secondary mucoceles, with a focus on radiographic features. As primary and superiorly positioned secondary maxillary sinus mucoceles are uncommon and their close proximity to the orbit predisposes the patient to significant morbidity, the authors expect that this report will contribute to a better understanding and diagnosis of maxillary sinus mucocele involving the orbit.

자발성 수액비루와 합병된 접형동 점액종 : 1예 보고 Case Report

김헌대,정용구,이훈갑,이기찬 대한신경외과학회 1983 Journal of Korean neurosurgical society Vol.12 No.4

Mucocele is commonly found in frontal sinus. Mucocele of sphenoid sinus is rare and only 100 cases have been reported since Burg's description in 1889. Their etiology is still conjectural. These lesions are potentially more serious and are often misdiagnosed as pituitary tumor. The author experienced a case of sphenoid sinus mucocele developed headache, fever and CSF rhinorrhea. Plain skull, cisternography brain CT scan help the diagnosis of sphenoid sinus mucocele. A transnasal approach is considered best for case with extensive sphenoid sinus mucocele with bone destruction in the floor of sella turcica. The headache, fever and CSF rhinorrhea improved after surgery.

Comparison of Clinical Characteristics between Primary and Secondary Paranasal Mucoceles

이경철,이남훈 연세대학교의과대학 2010 Yonsei medical journal Vol.51 No.5

Purpose: Paranasal sinus mucocele is a benign, expansile mass which can occur as a result of trauma or spontaneous obstruction of a sinus tract. The purpose of this study was to describe and compare the clinical characteristics of primary mucoceles occurring in patients with no previous sinus surgery history or known cause of mucoceles and secondary mucoceles resulting as a complication following endoscopic sinus surgery or the Caldwell-Luc operation. Materials and Methods: We performed a retrospective chart review of 33 cases of primary mucoceles and 60 cases of secondary mucoceles which were diagnosed and surgically corrected between 1996 and 2008. Results: The most common presenting symptoms in primary mucoceles were nasal obstruction (19.4%) and rhinorrhea (17.7%). In secondary mucoceles, the most common symptoms were cheek pain (31.7%) and nasal obstruction (18.3%). The most common origins of primary mucoceles were the ethmoid sinus (45.5%) and the maxillary sinus (18.2%). In secondary mucoceles, the maxillary sinus was the most common site (86%), followed by the ethmoid sinus (7.1%). All patients with secondary mucoceles had a history of sinus surgery. Conclusion: The maxillary sinus was the most common site of secondary mucoceles while the ethmoid sinus was the most common origin of primary mucoceles. Cases of secondary mucoceles that occurred following sinus endoscopic surgery developed more frequently in the ethmoid sinus than in those following the Caldwell-Luc procedure, therefore, we suggest that the incidence of maxillary sinus mucoceles in the Asian population would decrease as the rate of endoscopic sinus surgery increases.

유방에 발생한 점액류 유사 종양의 방사선학적 소견

강두경,조재현,정용식,임현이 대한영상의학회 2004 대한영상의학회지 Vol.50 No.6

Purpose: To evaluate the mammographic and ultrasonographic findings of mucocele-like tumors. Materials and Methods: Twelve breast lesions from 1994 through 2004, coded as mucocele or mucocele-like tumors, were retrieved from the surgical pathology database files at our institution. Eleven of the patients had undergone mammography, and sonography had been performed in all 12 patients. We retrospectively reviewed the mammographic, sonographic and pathologic findings. Results: The mammographies showed calcifications alone (n=6), calcification with mass or asymmetric density (n=3), and normal mammogram (n=2). The shapes of the calcifications were pleomorphic (n=4, 44.4%), amorphous (n=3, 33.3%) and round (n=2, 22.2%). Sonography was performed in all patients (n=12) and showed cysts (n=8), cystic mass (n=2), tubular hypoechoic structure (n=1) and hypoechoic mass (n=1). Pathologic examination revealed 5 cases of benign mucocele-like tumor that included epithelial hyperplasia without atypia (n=2) and atypical ductal hyperplasia (n=4), and 3 cases of associated intraductal carcinoma. Calcification was more frequently detected in the mucocele-like tumors with atypical ductal hyperplasia or intraductal carcinoma than in the benign tumors. Pleomorphic calcification was only visualized in those cases involving atypical hyperplasia or intraductal carcinoma. Of the 9 cases of calcification seen in the mammograms, 7 cases (77.8%) were detected in the associated sonograms and all were located within the lesion. Conclusion: The most common mammographic finding of mucocele-like tumors was segmentally distributed pleomorphic or amorphous calcifications, and the most common sonographic finding was cyst or cystic mass. 목적: 유방에 발생한 점액류 유사 종양(mucocele-like tumor)의 특징적인 유방촬영술 및 초 음파소견을 알아보고자 한다. 대상과 방법: 1994년 9월 부터 2004년 1월까지 본원에 내원하여 병리조직학적으로 점액류 유 사 종양으로 확진된 12명의 환자 12예를 대상으로 후향적으로 유방촬영술 및 초음파소견을 분석하였다. 결과: 12명중 11명이 유방촬영술을 시행하였고 석회화 6예, 비대칭 음영 또는 종괴를 동반한 석회화가 3예로 9예(81.8%)에서 석회화를 보여 주된 소견 이었으며 모양은 다형성이 4예 (44.4%), 비정형이 3예(33.3%), 원형이 2예(22.2%)이고, 분포는 구역성이 6예(66.7%), 군 집성이 3예(33.3%)였다. 2예는 유방촬영술에서 정상이었다. 초음파는 12명 모두에서 시행하 였고 낭종이 8예, 낭성종괴가 2예로 대부분의 경우(10예, 83.3%)에서 낭종 및 낭성종괴로 보 였고 분지하는 관형 저에코 구조물이 1예, 저에코 종괴가 1예였다. 병리학적 진단은 2예의 상 피세포증식을 포함한 양성 점액류 유사종양이 5예, 비정형 유관상피세포증식을 동반한 경우가 4예, 상피내암을 동반한 경우가 3예였다. 석회화는 양성 점액류 유사종양 보다 비정형 유관 상 피증식이나 상피내암을 동반한 경우에서 좀더 흔한 소견이었고, 이중 6예(85.7%)가 비정형 또는 다형성 석회화였다. 특히 다형성 석회화는 비정형 유관 상피증식을 동반한 경우와 상피 내암을 동반한 경우에서만 관찰되었다. 유방촬영술에서 석회화가 보였던 9예 중 7예(77.8%) 에서 초음파에서 석회화가 관찰되었으며 모두 병변내에 위치하였다. 결론: 점액류 유사 종양은 유방촬영에서는 구역성 분포를 보이는 다형성 및 비정형 석회화가, 초음파에서는 석회화를 동반하는 낭종이나 낭성종괴가 주된 소견이었다.

우연히 발견된 충수돌기 점액류종 1예

권성일,김규종,이지영,김동완,노치완,박무인,박선자,구자영,백승언 고신대학교(의대) 고신대학교 의과대학 학술지 2000 고신대학교 의과대학 학술지 Vol.15 No.1

Mucocele of the appendix is an uncommon disorder which is rarely diagnosed prior to a laparotomy. With progress in diagnostic procedures, such as the use of colonoscopy, ultrasonography, and computed tomography, preoperative diagnosis of the appendiceal mucocele has become possible. There have been several reported cases of appendiceal mucocele in which various symptoms and signs were present. In this case, a 50-year old female patient visited our hospital because of constipation and rectal bleeding, and then she had an incidental finding of mucocele of the appendix during colonoscopic evaluation for constipation and rectal bleeding. We have experienced the case of preoperatively diagnosed appendiceal mucocele by a colonoscopy and abdominal CT and barium enema in which she was operated and the surgical specimen revealed appendiceal mucocele.

충수돌기 점액낭종의 임상적 고찰

조진범(Jin Bum Cho),조항주(Hang Joo Cho),신옥란(Ok Ran Shin),김기환(Kee Hawn Kim),안창혁(Chang Hyeok Ahn),김정수(Jeong Soo Kim),유승진(Seung Jin Yoo),임근우(Keun Woo Lim),김지일(Ji Il Kim) 대한외과학회 2008 Annals of Surgical Treatment and Research(ASRT) Vol.74 No.6

Purpose: A mucocele of the appendix is an uncommon pathology, representing 0.2% to 0.3% of all appendix specimens. It is often diagnosed clinically as a result of its ability to cause signs and symptoms similar to those of acute appendicitis. If it is asymptomatic, it is often detected as an incidental finding during ultrasonography, computed tomography, radiographic examination of the gastrointestinal tract, or laparotomy. The purpose of this study was to identify the clinical features of mucocele of the appendix. Methods: We describe 35 cases of mucocele of the appendix diagnosed at Uijeongbu St. Mary’s hospital between January 1993 and December 2006. We analyzed demographic, clinical, and pathologic data of all the cases. Results: A total of 12 males and 13 females with mean age of 54.7±14.9 years are described. The peak incidence occurred in the seventh decade (34.3%). Sixteen patients presented with symptoms and signs similar to those found in acute appendicitis. Ten patients complained of a palpable mass, 2 patients complained of non-specific abdominal pain, and 7 patients were asymptomatic. Fourteen cases were diagnosed preoperatively, and 3 cases were discovered incidentally. Pathologic examination revealed mucosal hyperplasia in 20% of the cases, cystadenoma in 71%, and cystadenocarcinoma in 9%. The mean age of cystadenocarcinoma patients was older than the mean age of mucosal hyperplasia patients, and the diameter of the appendix was larger in cystadenoma patients than in mucosal hyperplasia patients. Conclusion: The preoperative diagnosis of appendiceal mucocele is very important to make in order to facilitate treatment planning and avoid inadvertent rupture of the mucocele during operation. We recommend more diagnostic studies in cases of suspected mucocele. Mucocele of the appendix must be included in the differential diagnosis of patients with pain in the right iliac fossa, patients older than 40 years of age, patients suffering from long-term symptoms, and patient with a palpable mass in the right iliac fossa.