Huge Plunging Ranula

Abstract

Ranula is a form of mucocele which specifically occurs in the floor of the mouth in association with the ducts of the submaxillary or sublingual gland. The term Ranula is derived from the Latin word Rana which means ‘Belly of frog’, because the lesions in the floor of the mouth resemble the bulging underbelly of a frog. The formation of ranula is thought to be due to the excretory duct rupture followed by extravasation and accumulation of saliva into the surrounding tissue. The accumulation of mucous in the surrounding connective tissue forms a pseudocyst that lacks an epithelial lining. Ranulas have classically been divided into simple and diving/plunging/cervical. Simple ranulas remain confined to the sublingual space, whereas diving ranulas extend beyond it [1]. Plunging ranula though rare are well documented causes of neck swelling. It is accepted that they arise as a result of extravasation of saliva from the sublingual gland through a hiatus in the mylohyoid muscle. If the only presentation is a cervical swelling, diagnosis can be difficult and advanced diagnostic technique like CT plays an important role in diagnosis.