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.
§ figuresFigures (3)
Fig. 1Ranula in a human
“Ranula human 09” · Ph0t0happy · CC BY-SA 3.0 · Wikimedia Commons
Fig. 2Ranula in 55-year-old woman.
“Ranula” · Klaus D. Peter, Wiehl, Germany · CC BY 2.0 de · Wikimedia Commons
Fig. 3Ranula on the floor of the mouth
“Ranula large” · Dikkisherpa5 · CC0 · Wikimedia Commons
Verified open-access images only, reproduced for education under their stated licences · no AI-generated or illustrative artwork · Ranula figures pending faculty review.
§ 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:
§ evidenceReferences & Evidence
Current Classification
WHO Classification of Tumours Online — Head and Neck
IARC / WHO · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Evidence summary
Highest level of evidence linked to this page: WHO / Official Classification.
- L1 · Classification — 1
- L3 · Systematic review — 1
- L6 · Textbook — 3
1 linked source was published from 2024 onwards. Where guidance is limited or contested, rely on the higher-level sources above rather than this summary. Educational use only — not a substitute for clinical judgement.
Content last reviewed
September 2026
Evidence last reviewed
September 2026
Next scheduled review
September 2027
Review status
EVIDENCE REVIEWED
Search latest PubMed evidence
Last literature search: 7 September 2026
Current Classification
IARC / WHO. IARC · 2022
Continuously updated online edition of the WHO head and neck tumour classification.
Systematic Reviews & Meta-Analyses
Kallas-Silva L, Azevedo MFD, de Matos FCM et al.. Brazilian journal of otorhinolaryngology · 2023 · 89(5):101293
Comprehensive review of sialendoscopy for obstructive and inflammatory major salivary gland disease.
Histopathology References
Barnes L. CRC Press · 2008
Detailed histopathological reference for head and neck diagnostic criteria.
Textbook References
Neville BW, Damm DD, Allen CM et al.. Elsevier · 2024
Standard reference textbook of oral and maxillofacial pathology used throughout this atlas.
Rajendran R, Sivapathasundharam B. Elsevier · 2020
Undergraduate and postgraduate oral pathology textbook widely used in BDS and FCPS curricula.
Additional sources cited on this page
- Neville BW. Oral & Maxillofacial Pathology, 4e
Draft — pending faculty review. Educational use only; verify against current guidelines and primary sources before clinical application.