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. 2011;2(6):90-2.
doi: 10.1016/j.ijscr.2011.02.005. Epub 2011 Mar 3.

Sublingual-plunging ranula as a complication of supraomohyoid neck dissection

Eva-Maria Dietrich  1 , Banikas Vasilios, Lazaridou Maria, Papaemmanouil Styliani, Antoniades Konstantinos
Affiliations

Sublingual-plunging ranula as a complication of supraomohyoid neck dissection

Eva-Maria Dietrich et al. Int J Surg Case Rep. 2011.

Abstract

Ranulas are rare cystic lesions resulting from damage or rupture of one or more of the ducts of the sublingual gland, that lead to mucus extravasation or dilatation of the gland's duct. Extravasation cysts are more common than retention cysts. We present a case of a 45-year-old male with a squamous cell carcinoma of the ventral surface of the tongue that was treated with excision of the oral lesion and bilateral supraomohyoid neck dissection without supplementary radiotherapy. A left myocutaneous platysma flap was raised for defect closure. Ten months postoperatively he presented complaining of swelling of the right submandibular region. The diagnosis, based on his medical anamnesis and the CT imaging, was a sublingual-plunging ranula. It is postulated that the ranula resulted from damage to the ducts of the sublingual gland during selective neck dissection. One year postoperatively there are no signs of recurrence either of the ranula or of the cancer. We suggest that sublingual gland excision and intraoral cyst marsupialization is a logical treatment for sublingual-plunging ranulas.

Keywords: Cervical ranula; Oral cancer; Plunging ranula; Ranula; Squamous cell carcinoma (SCC); Supraomohyoid neck dissection (SND).

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Figures

Fig. 1
Fig. 1
Intraoral view. Sublingual swelling protruding into the floor of the mouth.
Fig. 2
Fig. 2
Computer Tomography (CT), axial view. A low-attenuation collection (mucoid) in the submandibular-lateral pharyngeal region in continuity with the sublingual space.
Fig. 3
Fig. 3
Cystic wall devoid of epithelium (black arrows), consisting of loose fibroconnective tissue, inflammatory cells and dilated vessels (100×, H + E).
Fig. 4
Fig. 4
Dilated salivary gland duct (not filled arrows) and cystic wall devoid of epithelium (filled black arrows) (40×, H + E).
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References

    1. Horiguchi H., Kakuta S., Nagumo M. Bilateral plunging ranula. A case report. Int J Oral Maxillofac Surg. 1995;24:174–175. - PubMed
    1. Lida S., Kogo M., Tominaga G., Matsuya T. Plunging ranula as a complication of intraoral removal of a submandibular sialolith. Br J Oral Maxillofac Surg. 2001;39:214–216. - PubMed
    1. Balakrishnan A., Ford G.R., Bailey C.M. Plunging ranula following bilateral submandibular duct transposition. J Laryngol Otol. 1991;105:667–669. - PubMed
    1. Davison M.J., Morton R.P., McIvor N.P. Plunging ranula: clinical observations. Head Neck. 1998;20:63–68. - PubMed
    1. Morton R.P., Ahmad Z., Jain P. Plunging ranula: congenital or acquired? Otolaryngol Head Neck Surg. 2010;142:104–107. - PubMed