RESUMEN
Mucoceles are benign lesions of the oral cavity that develop as a result of retention or extravasation of mucous material from minor salivary glands. Congenital mucoceles are very rare. These lesions in newborns may interfere with breastfeeding and may even compromise respiratory function. A patient with a congenital mucocele diagnosed by prenatal ultrasound screening showing a cystic lesion of the tongue is presented herein. The physical examination, lesion evolution and imaging are described, together with the surgical management, histopathology and two-year follow-up. Early clinical assessment, differential diagnosis and magnetic resonance imaging allow clinicians to diagnose and treat this rare congenital condition with surgery in early infancy.
Asunto(s)
Mucocele/congénito , Enfermedades de la Lengua/congénito , Lengua/patología , Diagnóstico Diferencial , Humanos , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Mucocele/diagnóstico , Enfermedades de la Lengua/diagnósticoAsunto(s)
Obstrucción del Conducto Lagrimal/complicaciones , Mucocele/complicaciones , Síndrome de Dificultad Respiratoria del Recién Nacido/etiología , Dacriocistorrinostomía , Diagnóstico Diferencial , Drenaje/métodos , Endoscopía , Femenino , Estudios de Seguimiento , Humanos , Recién Nacido , Obstrucción del Conducto Lagrimal/congénito , Mucocele/congénito , Síndrome de Dificultad Respiratoria del Recién Nacido/diagnóstico , Síndrome de Dificultad Respiratoria del Recién Nacido/cirugía , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: The purpose of this series is to present our experience with cases of dacryocystocele diagnosed prenatally. The role of prenatal 3-dimensional sonography, as an adjunct to 2-dimensional sonography, in the prenatal assessment of these cases is emphasized. METHODS: A retrospective review of cases was conducted. Information was obtained by reviewing the sonographic reports and medical records. Outcomes were obtained from the referring obstetricians or directly from the parents. RESULTS: Ten fetuses had the diagnosis of a congenital dacryocystocele at a median gestational age of 30.1 weeks (range, 27-33 weeks). In 6 cases, the cystic lesion was unilateral, and in 4 it was bilateral, with a mean largest diameter at the time of diagnosis of 7.5 mm (range, 4-11 mm). There were no other associated findings. Three-dimensional sonography, carried out in 3 cases, clearly depicted the anomaly, the degree of intranasal extension, and swelling below the medial canthal area. Spontaneous resolution was documented prenatally in 5 fetuses, and 1 additional case resolved between the last prenatal scan and the delivery. There were no reported long-term complications associated with this finding, although 1 infant required probing at 2 months of age to resolve the dacryocystocele. CONCLUSIONS: Prenatal diagnosis of dacryocystocele is straightforward. A considerable number of lesions are bilateral, and many resolve in utero spontaneously or neonatally after minimal intervention. For those not resolving by the time of the delivery, ophthalmologic or rhinologic consultation is warranted because of potential complications. Three-dimensional sonography may provide a noninvasive method for evaluating these cystic masses and may contribute to the avoidance of additional diagnostic techniques in the neonatal period.