Soft Tissue Lesions
Ranula
aka Sublingual Mucocele · Plunging Ranula (if extends through mylohyoid)
Mucocele arising in the floor of mouth from sublingual gland, appearing as a blue, translucent swelling resembling a frog's belly.
§ overviewOverview
Mucous extravasation (or rarely retention) cyst of the floor of mouth originating from the sublingual gland or minor salivary glands.
§ icdICD Classification
K11.6
§ etiologyEtiology
- 01Trauma/obstruction of sublingual or submandibular duct
§ epidemiologyEpidemiology
Less common than lip mucocele; young adults.
§ pathogenesisPathogenesis
Duct rupture → mucin extravasation in floor of mouth → fluctuant cystic swelling. Plunging ranula dissects through mylohyoid.
§ clinicalClinical Features
- 01Unilateral, bluish, translucent swelling floor of mouth
- 02Soft, fluctuant
- 03May deviate tongue
- 04Plunging ranula: submandibular swelling with floor of mouth component
§ differentialDifferential Diagnosis
- 01Dermoid cyst
- 02Lymphangioma
- 03Lipoma
- 04Submandibular duct obstruction
§ investigationsInvestigations
- 01MRI (plunging ranula)
- 02Clinical + ultrasound
§ treatmentTreatment
- 01Marsupialization (simple ranula)
- 02Excision of sublingual gland (recurrent/plunging)
- 03Transcervical approach for plunging ranula
§ complicationsComplications
- 01Recurrence
- 02Infection
§ prognosisPrognosis
Good; gland excision prevents recurrence.
§ examKey Examination Points
- 01Ranula = mucocele of floor of mouth
- 02Plunging = through mylohyoid
- 03Marsupialization or gland removal
§ revisionQuick Revision Summary
- 01Blue, frog belly swelling
- 02Plunging = submandibular extension
- 03Excise sublingual gland for recurrence
§ vivaBDS Viva Questions
- 01What is a plunging ranula?
- 02Describe treatment options.
- 03How do you differentiate from dermoid cyst?
§ mcqsMCQs — Assessment (3)
Question 1
Ranula arises from:
Question 2
Plunging ranula extends through:
Question 3
Definitive treatment for recurrent ranula:
References
- Neville BW. Oral & Maxillofacial Pathology, 4e
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.