Occurrence of dermoid cyst in the floor of the mouth: the importance of differential diagnosis in pediatric patients

Abstract Lesions in the floor of the mouth can be a challenging diagnosis due to the variety of pathological conditions that might be found in this area. Within a broad range of lesions, attention has to be addressed to those that require specific management, such as a dermoid cyst (DC) and a ranula. Especially in pediatric patients, in whom the failure of diagnosis can postpone the correct treatment and cause sequelae later in life. DC, a developmental anomaly, is managed primarily by surgical resection. On the other hand, ranula is a pseudocyst that may be treated by marsupialization. This article reports a large and painful lesion in the floor of the mouth in a pediatric patient. With a diagnostic hypothesis of ranula, two surgical interventions were performed, but there were recurrences of the lesion. Subsequently, the patient was referred to the Oral and Maxillofacial Surgery Unit for re-evaluation. Computed tomography showed a semi-transparent image suggesting a cystic formation. Another surgical procedure was performed where the lesion was completely removed. Anatomopathological analysis confirmed the diagnosis of DC. The five-year follow-up showed no signs of recurrence. This article indicates that although DC in the floor of the mouth is rare, it should be considered in the differential diagnosis of other diseases in this area. This precaution may be particularly important in the following circumstances: 1) Similar lesions that have different therapeutic approaches and, 2) To prevent future sequelae in pediatric patients.

Plunging Ranulas Revisited: A CT Study with Emphasis on a Defect of the Mylohyoid Muscle as the Primary Route of Lesion Propagation

OBJECTIVE: The purpose of this study was to clarify the pathogenesis of plunging ranulas in regard of the pathway of lesion propagation using CT scans. MATERIALS AND METHODS: We retrospectively reviewed CT scans of 41 patients with plunging ranula. We divided plunging ranulas into two types: type 1 was defined as those directly passing through a defect of the mylohyoid muscle with the presence (type 1A) or absence (type 1B) of the tail sign and type 2 as those through the traditional posterior route along the free edge of the mylohyoid muscle. Images were also analyzed for the extent of the lesion in respect to the spaces involved. As for type 1 lesions, we recorded the location of the defect of the mylohyoid muscle and the position of the sublingual gland in relation to the defect. RESULTS: CT scans demonstrated type 1 lesion in 36 (88%), including type 1A in 14 and type 1B in 22, and type 2 lesion in 5 (12%). Irrespective of the type, the submandibular space was seen to be involved in all cases either alone or in combination with one or more adjacent spaces. Of the 36 patients with type 1 lesions, the anterior one-third was the most common location of the defect of the mylohyoid muscle, seen in 22 patients. The sublingual gland partially herniated in 30 patients. CONCLUSION: Our results suggest that the majority of plunging ranulas take an anterior shortcut through a defect of the mylohyoid muscle.

Tratamento de rânula pela técnica de marsupialização: relato de caso clínico / Ranula treatment by marsupialization technique: clinical case report

As rânulas são fenômenos extensos de retençãode saliva que ocorrem no assoalho bucal, principalmentena região da glândula sublingual. Elaspodem causar a elevação da língua e interferircom a fala e a deglutição. O tratamento é cirúrgicopor meio da marsupialização da rânulaou da remoção definitiva da glândula sublingualenvolvida. A técnica da marsupialização é umaalternativa cirúrgica a ser considerada, visto queé um procedimento simples e pouco traumático,além de apresentar prognóstico favorávelquando bem indicado. O objetivo deste trabalhoé relatar um caso clínico de rânula tratadopela técnica de marsupialização, além de fazerconsiderações sobre as formas de tratamentodessa lesão glandular benigna.

The ranula phenomena are extensive retentionof saliva, which occur in the floor of the mouth,especially in the region of the sublingualgland. They can cause the elevation of the tongueand interfere with speech and swallowing.Treatment is by surgical marsupialization of theranula or permanent removal of the sublingualgland involved. The technique of marsupializationis a surgical alternative to be considered,since it is a simple and less traumatic, and presentsa favorable prognosis when properly indicated.The objective of this study is to reporta clinical case of ranula treated by marsupializationtechnique, in addition, to show considerationson how to treat this benign glandularlesion.

Tratamento do fenômeno de extravasamento/retenção de muco pela técnica de micro-marsupialização modificada associado ou não ao uso do laser de baixa intensidade: ensaio clíncio controlado e randomizado

Avaliar o efeito do laser de baixa intensidade (LBI) em reduzir recorrências e aliviar a dor tratamento do fenômeno de extravasamento/retenção de muco pela técnica de micro-marsupialização modificada. Materiais e método: seis pacientes com rântulas orais e mucoceles selecionadas foram submetidos ao tratamento de micro-marsupialização (grupo controle) e onze pacientes foram submetidos ao tratamento de micro-marsupialização associado ao LBI (grupo laser). Os pacientes do grupo laser foram irradiados utilizando um laser de Arseanato de Gálio-Alumínio (AsGaAl) em um comprimento de onda de 660 nm em modo contínuo, com uma potência de 100 mW...