Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2014 Jul-Dec;4(2):230-3.
doi: 10.4103/2231-0746.147158.

A rare cause of lateral facial swelling

Sujata Mohanty  1 , Ujjwal Gulati  1 , Vandana  1 , Sapna Singh  2
Affiliations
Case Reports

A rare cause of lateral facial swelling

Sujata Mohanty et al. Ann Maxillofac Surg. 2014 Jul-Dec.

Abstract

A case of chronic, recurrent and asymptomatic facial swelling in a young male is presented. Swelling extended from lower midface to upper lateral neck and right commissure to anterior massetric border. History, clinical signs and symptoms and examination pointed towards the benign nature of the swelling. Fine-needle aspiration cytology tapered the diagnostic possibilities to a salivary cyst or pseudocyst. Ultrasonography identified the lesion to contain echogenic fluid with irregular borders. "Tail sign" was absent on contrast magnetic resonance imaging, excluding the involvement of the sublingual gland. Surgical excision of the lesion was done along with submandibular gland as both were in continuity via a bottle-neck tract. Final histopathological diagnosis was that of the submandibular gland extravasation phenomenon. As per the best of our knowledge, it is the first case report of a submandibular gland extravasation causing swelling in a retrograde direction onto the face.

Keywords: Extravasation phenomenon; pseudocyst; submandibular gland; tail sign.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Preoperative presentation of patient showing facial extension of submandibular swelling
Figure 2
Figure 2
(a) T1-weighted (T1W) axial magnetic resonance imaging (MRI) showing a well marginated lesion in the right submandibular region. The lesion shows a hypointense signal with no septations. (b) Fat suppressed T2W axial MRI showing the lesion to be high signal. The compressed submandibular gland is seen lying adjacent to the lesion. (c) Fat suppressed T2W axial MRI showing the lesion to have a small projection towards the floor of the mouth. The typical “tail sign” of a plunging ranula was not seen. (d) Post-contrast axial MRI showing the lesion having a thin peripheral rim enhancement
Figure 3
Figure 3
Exposure via submandibular approach
Figure 4
Figure 4
Facial extension of lesion dissected (circled) and found to be in continuity with submandibular gland
Figure 5
Figure 5
Resected lesion and submandibular gland
Figure 6
Figure 6
(a) Superficial infiltration of chronic inflammatory cells admixed within loosely textured collagen fibers (H and E, ×100). (b) Loosely textured collagen fibers with numerous mucinophages (PAS, ×400)
Figure 7
Figure 7
Six months postoperative photograph
See this image and copyright information in PMC

References

    1. Neville BW, Damm DD, Allen CM, Bouquot JE. Oral and Maxillofacial Pathology. 2nd ed. Philadelphia, PA: Saunders; 2002. pp. 391–2.
    1. Harrison JD, Sowray JH, Smith NJ. Recurrent ranula. A case report. Br Dent J. 1976;140:180–2. - PubMed
    1. Amaral MB, De Freitas JB, Mesquita RA. Upgrading of the micro-marsupialisation technique for the management of mucus extravasation or retention phenomena. Int J Oral Maxillofac Surg. 2012;41:1527–31. - PubMed
    1. Lai JB, Poon CY. Treatment of ranula using carbon dioxide laser: Case series report. Int J Oral Maxillofac Surg. 2009;38:1107–11. - PubMed
    1. Zhao YF, Jia Y, Chen XM, Zhang WF. Clinical review of 580 ranulas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98:281–7. - PubMed

Publication types