Eleven years ago, an X-ray showed a large (about the diameter of a dime) round growth above my upper right teeth, apparently in a sinus. My dentist consulted an oral surgeon, who told her it was a mucocele and I shouldn't worry unless it caused sinus infections or other problems. I do have some occasional sinus infections but not enough to make me want surgery. In the last month I have had five nosebleeds that were difficult to stop, also on the right side. The latest X-ray continues to show the growth, only it looks a little bigger. Could this be a mucocele or something else? Could the growth and the bleeds be related?

S.

I suspect that your oral surgeon was almost correct. These little guys are more correctly called mucus retention cysts, and they rarely require surgical intervention. Unlike mucoceles, which lack a true "wall," mucus retention cysts have a very well-defined boundary. Think of them as water balloons (or, uh, mucus balloons) and you will have a pretty good grasp on the situation.

You state that the lesion looks only "a little bigger" on the latest X-ray. This supports the diagnosis of a mucus retention cyst. Could it be something else? Of course it could -- and the list of possible "something elses" is long. Since you are having nosebleeds, your unspoken fear is that this lesion is actually a cancer. However, if it has grown only slightly in the last 11 years, cancer is a very unlikely diagnosis.

Unlikely ... but not impossible. Some benign tumors may give rise to a cancer after many, many years of innocent behavior. One such tumor that arises in the nose and sinuses is the polyp-like inverted papilloma. Since some benign lesions can occasionally turn evil, I cannot tell you, "Hey, don't worry about it!"

Particularly problematic is the fact that you have been examined with plain X-rays rather than CT scans. If this lesion has turned nasty (the correct medical terminology for "turn nasty," by the way, is "undergo malignant degeneration"), a CT would be more likely to show this than would a plain film, since CT scans are far more detailed. Also problematic: You have been examined by a dentist and an oral surgeon, not an ear, nose and throat doctor (ENT). An ENT would be able to assess the seriousness of this situation more readily than a dentist. An ENT could determine if your nosebleeds are related to the sinus mass, and an ENT has the expertise to treat your nosebleeds, whether they are related to the sinus mass or not.