A plunging ranula is a rare phenomenon that represents mucous extravasation extending through or behind the mylohyoid. The mucous dissects the tissue planes inferiorly and usually manifests as a swelling in the submental or submandibular regions. Some plunging ranulas are believed to result from disruption of excretory ducts that originate from the sublingual gland. The currently accepted definitive treatment of a plunging ranula is resection of the ipsilateral sublingual gland and evacuation of the cyst with removal of the pseudocapsule. There have been no reported cases of "ascending" ranulas into the parapharyngeal or pterygomaxillary space. The following represents the first known case that involved an extensive ascending and plunging ranula in a pediatric patient, which recurred despite complete excision of the ranula and sublingual gland. IRB approval was not required per institutional policy on retrospective case reports.
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Surgical management of a large plunging ranula: A case report and review of diagnostic challenges.
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Stomatology Faculty, Kabul University of Medical Sciences, Kabul, Afghanistan.
Introduction: Ranulas are mucous cysts that arise from the sublingual gland due to ductal obstruction or trauma. Plunging ranulas, a rare variant, extend into the neck and often present diagnostic challenges. Definitive surgical management is necessary to prevent recurrence and ensure successful outcomes.
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Department of Pathology Anatomy, Faculty of Medicine, University of Padjadjaran, Dr. Hasan Sadikin General Central Hospital, Bandung, West Java, Indonesia.
Plunging ranula is the extravasation of saliva from the sublingual gland caused by trauma or obstruction of the duct, extending through a defect in the mylohyoid muscle into the submandibular gland. The prevalence of plunging ranula is estimated to be about 2.6 per 100,000 cases with mostly unilateral lesions.
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Plunging ranulas are rare retention pseudocysts of the major salivary glands, most often of the sublingual gland, and usually occur in individuals from the first to the sixth decade of life with female predominance. Given their similar location and physical and imaging characteristics to thyroglossal cysts, distinguishing the two lesions is often a differential diagnostic dilemma even for the experienced physician. This case report presents a 42-year-old man for whom a preliminary diagnosis of a thyroglossal duct cyst was made based on a physical examination.
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Synovial sarcomas are uncommon and highly aggressive sarcomas. Typically, they start in the soft tissues of the extremities, although they may develop in the head and neck region in rare cases. When they do, they usually present with localized symptoms in the affected area.
View Article and Find Full Text PDFArticle Synopsis
- A plunging ranula, a type of sublingual salivary gland cyst, can initially be mistaken for a vallecular cyst, but ultrasound and MRI are important for accurate diagnosis.* -
- The case presented involves an 18-year-old male with a rare form of plunging ranula that extends above the mylohyoid muscle into the oropharynx without a typical cervical swelling.* -
- The report emphasizes the importance of using MRI for distinguishing between diagnoses and highlights the need for establishing guidelines for further investigations in such atypical cases.*
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