Imaging Implications in Plunging Ranula- A Rare Case Report

Abstract

Plunging ranula is an intraoral swelling plunging deep into neck and extending beyond the floor of the mouth. Clinical diagnosis is challenging to the clinician as, they mimic other neck lesions like reactive lymphadenopathy, cystic hygroma, thyroglossal duct cyst, abscess and so on. Herein, the authors presented a case of a 34-year-old male with history of swollen neck for past three months reported to the outpatient ward. On examination apart from the extraoral swelling in the left side of the neck, there was also an evidence of dome-shaped fluctuant deep seated swelling in the floor of the mouth. Biochemical analysis of the patient was within the normal limits. Further two-dimensional (2D) radiographs findings also, were non contributory. An anechoic presentation indicating fluid-filled sac was evident on ultrasound imaging. Sialogram of the case revealed the classic tail sign indicating a defect beyond the mylohyoid muscle; thus, three-dimensional (3D) imaging paves the way for deriving a final diagnosis. Furthermore, patient has been enlightened about the available treatment options and is under regular follow-up. Adding as a novelty, the present case is discussed with complete clinical, videographic and radiographic presentation of plunging ranula.