Recurrent extensive plunging ranula: A rare case

Area of Science:

• Otolaryngology
• Oral and Maxillofacial Surgery
• Surgical Pathology

Background:

• Plunging ranula (PR) is an uncommon cystic mass originating from the sublingual salivary gland, typically presenting in the floor of the mouth.
• PR commonly affects males in their third decade, but its exact prevalence remains unknown.
• This lesion can extend beyond the oral cavity into the neck, sometimes without initial intraoral manifestations.

Observation:

• A rare case of an extensive plunging ranula involving the parapharyngeal space is presented.
• The patient, a 17-year-old Saudi female, initially presented with submandibular and floor of mouth swellings.
• Diagnosis was challenging due to the absence of a typical intraoral lesion, necessitating detailed clinical and radiological evaluation.

Findings:

• The extensive PR reached the parapharyngeal space, posing diagnostic and management complexities.
• Absence of intraoral lesions complicates the diagnosis of plunging ranula.
• Detailed history, clinical examination, and radiological imaging are crucial for accurate diagnosis.

Implications:

• This case underscores the importance of considering plunging ranula in the differential diagnosis of neck masses, even without intraoral findings.
• Effective management involves complete surgical excision of the ranula and the involved sublingual gland.
• Further research into the prevalence and optimal diagnostic pathways for plunging ranula is warranted.