A case report of plunging ranula: an unusual case of mucous extravasation cyst

ABSTRACT

ranula or cervical ranula is amucous extravasation cyst of the sublingual gland. It is slightly common in females, shows no side preference, and is more prevalent in the second and third decades of life. It typically manifests as a painless, nonmobile swelling in the neck. The pathogenesis of plunging ranula is the discontinuities of the mylohyoid muscle in a position that would allow extravasation of sublingual gland mucin. The histologic appearance is characteristically of a cyst, devoid of epithelium or endothelium, with a vascular fibro-connective tissue wall containing some chronic inflammatory cells and macrophages stuffed with mucin. The correct diagnosis is essential for the most effective treatment, which is exicision of the sublingual gland. The plunging ranula must be differentiated clinically and histomorphologically from thyroglossal duct cyst, dermoid cyst, branchogenic cyst, lymphangioma, laryngocele, lipoma, hemangioma, cervial thymic cyst, cysts of the parathyroid or thyroid gland, lymphadenopathy, abscess, or tumor. We report a case and review the literatures, in our case, 23-year old man were diagnosis as plunging ranula after have been taken sialogam, MRI, etc. He underwent surgery via a cervical approach. The ranula reached the anterior neck by passing through a dehiscence in the mylohyoid muscle. A pseudocyst was extirpated. Although total sublingual gland excision was not performed, no recurrence was observed during 6 months follow-up periods.