50y/m/soft fluctuating swelling on lower lip since past 6 months/no pain or other symptoms. surgical excision done ! it begs question that how will you clinically be sure to differentiate lipoma/fibroma/myocele. I am sure you think its easy discussion. @Dr. Pyusha Jain @Dr. Debasish Sinha @Dr. Geetalima Dutta @Dr. Rohan Khandelwal @Dr. Krishna Mohan



Such nice explanation by Dr. Prasad, I agree with him. I further would like to add that it's typical site for Mucocele. Prior surgery it had colorless or bluish fluid in appearance whereas fibroma will be nodular , pink same as surrounding tissue and sessile. If during surgery you see mucinous exudate and bleeding then it should be Mucocele. Fibroma will have more of bleeding and not mucinous exudate . Though pre op pic could have been great help to decide but it's good to brush up some knowledge without help of technology :-)

Doc nice add on Thanks

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Thanks again dear Dr Tahir for a nice question. Lipoma Soft in consistency and slippery in nature. Fibroma Hard in consistensy, nodular asymptomatic tumor. This is a benign tumour of fibrous connective tissue that's result of reactionary connective tissue in response to trauma and irritation. Mucocele Is a benign lesion occurring in the buccal mucosa as a result of rupture of the salivary gland duct and consequent outpouring of mucin in to soft tissues. Usually caused by local trauma. The most frequent site is lower inner portion of lips. In the given case, a soft fluctuating swelling most probably is Lipoma.

always helpful ,sir

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it seems to be retention cyst lower lip

lower lip...is common site for mucocele...kindly ask for ne h/o lip bittin...trauma...in lips...

Submucous cyst near to blood vessel. Careful excision under local anesthesia to avoid recurrence.

Sub mucous cyst, advised surgery.

sub mucous cyst

excional biopsy

sub mucous cyst

Dr Tahir My suggestion is On examination Lipoma or Sialolipoma of lower lip is rare and on palpation will be firm mobile and you can feel the around the ledion, On remove a solid encapsulated mass. Mucocele will be soft to Touch and slightly compressible not mobile. On removal the capsule usually gets puncture and mucus discharge. Fibroma is firm or hard in palpation. On removal it's attached to surrounding tissue Needs deep excision. Cannot palpate around the lesion and Base will be indurated.

Thank you for your help. sir

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Thanks for enlightening Krishna sir

Thanks again dear Wasim
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