The domeshaped nodule has a smooth intact surface that imparts a pink, yellow, blue, or red color. The ranula is formed by saliva leaking from an injured sublingual salivary duct. A literature search revealed that prenatal diagnosis of ranula has been reported only once3. Occur when the simple ranula ruptures and is walled off by an inflammatory response. Pdf on jul 2, 2019, ayesha thabusum and others published ranula two case reports. Ranula clinical presentation, diagnosis and management. Ranulas are mucoceles or retention cysts formed by the extravasation of mucus from the sublingual gland, presumably due to continued production of saliva in the presence of ductal obstruction. Branchial theory suggests that incomplete obliteration of branchial cleft mucosa, which remains dormant until stimulated to grow later in life, results in cyst formation ascherson, 1832 am j pathol 1967. Ranula is a mucus extravasation cyst originating from the sublingual gland on the oor of the mouth. Apr 16, 2018 the mucus retention cyst has a presentation similar to that of a mucocele and a ranula, except that it does not fluctuate in size.
We describe a case of congenital ranula or retention salivary cyst diagnosed at 26 weeks of gestation. They result from obstruction of a sublingual gland or adjacent minor salivary gland with resultant formation of a mucous retention cyst 1,5. Histopathologically ranula consists of a central cystic. The differential diagnosis of submental and sublingual benign lesions are plunging ranula, thyroglossal duct cyst, cystic hygroma, mucocele, branchial. A mucocele is a benign, mucouscontaining cystic lesion of the minor salivary glands presenting as a distinct, fluctuant, painless swelling of the mucosa, especially the lower lip. Apr 16, 2018 collectively, the mucocele, the oral ranula, and the cervical, or plunging, ranula are clinical terms for a pseudocyst that is associated with mucus extravasation into the surrounding soft tissues. Sublingual epidermoid cyst resembling sublingual ranula. Partial sublingual glandectomy with ranula excision. We use cookies to make interactions with our website easy and meaningful, to better understand the use of our services, and to tailor advertising. Clinically they are characterized by single or multiple, soft, fluctuant nodule, ranging from the normal color of the oral mucosa to deep blue. Rarely, these ranulas may arise independent of oral swelling. The fluidfilled lesions tend to slowly enlarge with welldefined margins that are freely movable.
Plunging ranula in a 78 year old male a rare case report. It is defined as an extravasation of pseudocystic mucus and is subdivided into simple, where the volume increase occurs only on the floor of mouth and plunging. A ranula is a benign, mucouscontaining cyst of the sublingual salivary gland that is caused by either rupture or blockade of the salivary duct. Commonly ranula arises due to collection of saliva from sublingual salivary gland. Followup ultrasound scans revealed no changes in the size or the. An extravasation phenomenon is a tissue swelling that may occur as a result of pooling of mucus. John eveson, in diagnostic surgical pathology of the head and neck. Sep 01, 2014 a read is counted each time someone views a publication summary such as the title, abstract, and list of authors, clicks on a figure, or views or downloads the fulltext. A cyst on the floor of our mouth is called a ranula or froglike, and a cyst on the gum is known as an epulis. Marsupialisation, excision of the ranula alone and excision of the sublingual gland combined with the ranula resulted in recurrence rates of 66. A plunging ranula extends into the submandibular triangle of the neck. It may rarely originate from injury to the submandibular gland smg. The parotid gland is located in front of the ear, and it secretes its mostly serous saliva via the parotid duct. The american college of veterinary surgeons is the agency by which veterinarians are certified as specialists in surgery.
A case report of ranula treated with marsupialization and low. The salivary glands themselves are not affected in the surgical correction of a ranula. Clinically, cervical ranulas may simulate bursae, angiomas cystic hygroma, and other. These lesions can be acquired or congenital, and most are unilateral, although they can rarely be bilateral.
It is filled with saliva that has leaked out of a damaged salivary gland. In large sizes usg, ct and mri show this to be a plunging ranula, but histopathology confirms this to be epidermoid cyst. Collectively, the mucocele, the oral ranula, and the cervical, or plunging, ranula are clinical terms for a pseudocyst that is associated with mucus extravasation into the surrounding soft tissues. Bergmann and kuettner1 summarize the present knowledge as follows. Plunging ranulas, also known as deep, diving, cervical or deep plunging ranula, usually appear in conjunction with oral ranula. Unusual association of diseasessymptoms oral ranula in an. A case report of ranula treated with marsupialization and low level laser therapy dr. A 7yearold neutered female staffordshire bull terrier was referred for a suspected sublingual sialocoele or ranula.
This is often noted as a fluctuant, painless swelling of the neck or within the oral cavity. These lesions occur as the result of trauma or obstruction to the salivary gland excretory duct and spillage of mucin into the surrounding soft ti. Ranula is a mucus extravasation cyst originating from the sublingual gland on the floor of the mouth. A ranula, or mouth cyst, is indicated by blue swelling under the tongue. Obtaining a specimen for pathological examination is essential squamous cell carcinoma arising in the cyst wall of a ranula and papillary cystadenocarcinoma of. Ranula if on the floor of mouth arising from the sublingual gland plunging ranula if the mucin dissects through the mylohyoid muscle to involve the cervical area mucus escape reaction not to be confused with salivary duct cyst salivary retention cyst mucus retention cyst mucus duct cyst sialocyst. Ranula and the sublingual salivary glands clinical. Excision of the ranula was done and was successful. The mucocele and the oral ranula have a welldelineated cavity that contains free mucinous material. The term ranula is used to designate any cyst of the anterior part of the floor of the mouth. This test is called a histopathology and can confirm what is causing the enlargement.
May 22, 2016 ranula is a mucus extravasation cyst originating from the sublingual gland on the floor of the mouth. Cytopathological findings from fineneedle aspiration were indicative of either non. The mission of acvs is to advance the art and science of surgery and promote excellence in animal health care through research, education and service to the public. The cystic lesion is, however, confirmed histopathologically as ranula by the. Ranula definition is a cyst formed under the tongue by obstruction of a gland duct. Mucocele is a clinical term that includes mucus extravasation phenomenon and mucus retention cyst. Mucoceles develop as a result of changes to the minor salivary glands, leading to mucous accumulation and local swelling. Ranula is a mucocele occuring specifically in the floor of the mouth. Abstractthis study indicates that the ranula of dogs represents a sublingual salivary mucocele and not a dilated salivary duct, as it is not lined by an epithelium but by connective tissue.
Your veterinarian may also recommending imaging, such as xray or ct scan to see how far the cysts extend so they can plan a surgical approach. The exact prevalence of plunging ranula is not known, however, these lesions are considered uncommon. We report a case of a monthold girl with a congenital ranula in the oor of mouth. A ranula larger than 1 cm should be treated by removal of the offending sublingual gland. Prenatal diagnosis of ranula at 21 weeks of gestation. Of the 10 patients treated by partial sublingual glandectomy with ranula excision, only one experienced recurrence 10%, i. Giant sublingual epidermoid cyst resembling plunging ranula. Histology of synovial cysts of the spine shows varied types of cyst. A clear or bluish translucent growth on the floor of the mouth is the main symptom of a ranula. Unusual association of diseasessymptoms oral ranula in an hivpositive patient.
Sublingual infiltrative lipoma in a dog mimicking a ranula. Mucous retention cysts do have a true epithelial lining. Article information, pdf download for plunging ranula. Mouth cyst or mucous cyst types, causes, prevention. If it grows down into the neck it is called a plunging ranula. The term ranula is poorly understood and is frequently applied to a variety of cystic structures in the head and neck. Surgical treatment was performed 2 days after a nor. Canine ranulas, salivary mucoceles and branchial cysts. This creates an everted pouch that slowly heals, forming a new opening for the salivary duct. Ranula is a retention cyst of the sublingual gland, which, with progressive enlargement, may rupture and extend into the surrounding soft tissues as a pseudocyst. Deepthi gulivindala the dental clinic, hyderabad, india abstract oral ranula is a retention cyst arising from the sublingual gland on the floor of the mouth as a result of ductal obstruction and fluid retention. Plunging ranula in a 78 year old male a rare case report arunkumar kamalakaran 1, balaji jayaraman 2, saravanan balasubramaniam 3, rohini thirunavukkarasu 4. We describe a further case of congenital mucous cyst of the mouth. Ranulas arise either spontaneously or as a result of trauma to the floor of mouth, including surgery.
A 34year old malay gentleman had presented to our centre with a floor of mouth lesion that extended into the submental region. The simple ranula is a form of mucous retention cyst involving the ducts of the sublingual salivary gland and typically presents as an asymptomatic soft, fluidfilled mass in the lateral floor of mouth. Since the cyst resembles the bluish underbelly of a frog this is appropriate. Sialocele or salivary cyst overview a salivary mucocele is a collection of saliva that has leaked from a damaged salivary gland or salivary duct, and has accumulated in the tissues. Dec 30, 2012 oral mucocele is the most common benign minor accessory salivary gland lesion, caused due to mechanical trauma to the excretory duct of the gland.
Ranulas have classically been divided into simple and diving on the basis of the sublingual space, their site of origin 1 4. This may be done with full anesthesia or just sedation. Plunging epidermoid cyst of the floor of mouth is indeed an uncommon entity. In most cases mouth cysts are painless, but the mass may be large enough to interfere with eating, chewing and swallowing. Ranula retention cyst sublingual gland oral swelling. The ranula was treated first by marsupialization, but the cyst recurred after 1 week. Ranula is a retention cyst of the sublingual gland, which enlarges progressively and extends into the surrounding soft tissues. Salivary cysts chin and neck lumps in dogs petcoach. The incidence of congenital ranula is estimated to be 0. Mucocele of submandibular salivary gland mimicking deep. Sublingual epidermoid cyst simulating a plunging ranula. A case report of ranula treated with marsupialization and. Differential diagnosis of cystic lesions of the floor of the mouth is important because the recommended surgical technique is not exactly the same in all of them.
It is defined as an extravasation of pseudocystic mucus and is subdivided into simple, where the volume increase occurs. These lesions can be acquired or congenital, and most are unilateral, although they can rarely be. A pearshaped radiolucency causing displacement of the roots of vital maxillary lateral and cuspid teeth is characteristics of. Fluid from the obstructed gland dissects between the fascial planes and muscle of the base of the tongue to the submandibular space. Oral ranulas are due to mucus that pools above a muscle in the neck called the mylohyoid. Plunging ranula transoral resection sublingual gland aided. A ranula is a mucus extravasation cyst involving a sublingual gland and is a type of mucocele found on the floor of the mouth. These cysts can progress to a very large size lifting the oral mucosa and base of tongue and are known as ranula. The fetal karyotype was obtained by amniocentesis and chorionic villus sampling, and was normal. Case report a rare case of congenital ranula in an infant. The pathological condition called ranula from latin term, derived ran frog, and ula small. Plunging ranula now antiquated treatment see comments about contemporary treatment recurrent neck swelling after ranula resection plunging ranula management 20 yo with 7 month history of painless neck swelling without inciting eventmodified operative note.
Ranulas classically are cysts of salivary gland origin, usually the sublingual glands, of which two varieties are described. Salivary gland diseases sgd are multiple and varied in cause there are three paired major salivary glands in humans the parotid glands, the submandibular glands, and the sublingual glands, and about 800 minor salivary glands in the mucosa of the mouth. Ranula, retention salivary cyst, prenatal diagnosis abstract we describe a case of congenital ranula or retention salivary cyst diagnosed at 26 weeks of gestation. Current concept of pathophysiologic basis and surgical. The ranula is opened and its walls are basically turned inside out and sutured down to the lining of the mouth. Pathology outlines branchial pouch cleft anomalies. The primary reason for surgery on the sublingual gland is a ranula. A ranula consists of a central cystic space containing mucin and a pseudocyst wall composed of loose, vascularized connective tissues with absent of epithelial tissues. A plunging or diving ranula is a rare mucous fluid collection in the. Aug 28, 2017 a clear or bluish translucent growth on the floor of the mouth is the main symptom of a ranula.
Ranulas are rare mucoceles that occur in the floor of the mouth. A mucocele is defined as the pooling of mucin in a cystic cavity. If a ranula stays in the mouth underneath the tongue it is called a simple ranula. Plunging ranula transoral resection sublingual gland. The dissected specimen and histopathological examination revealed it to be a benign submandibular salivary gland cyst. The patient had a threeweek history of a soft, nonpainful, left submandibular swelling that had extended to the intermandibular and sublingual areas. Ranulas can be true cysts occurring due to ductal obstruction of the.
Pathology demonstrated a normal sublingual gland with mucocele and no. Sonographic findings included a large cystic mass with two components. A salivary cyst is an accumulation of saliva in the surgery. Followup ultrasound scans revealed no changes in the size or the position of the cyst. A plunging ranula is an extravasation of saliva from the sublingual gland due to trauma or obstruction of the duct. Clinical findings and imaging studies pointed towards the impression of a plunging ranula. Which histologic findings are characteristic of mucocele. Ranulae present as a swelling of connective tissue consisting of collected mucin from a ruptured salivary gland caused by local trauma. They dont typically cause pain, so you may not notice it until the cyst increases in size. A ranula is a fluid collection or cyst that forms in the mouth under the tongue. Ranula a ranula latin word rana, meaning frog describes a blue, translucent swelling in the floor of the mouth, reminiscent of the underbelly of a frog. We report a case of a 4monthold girl with a congenital ranula in the floor of mouth.
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