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[Plunging ranula presenting as a giant retroauricular mass: A case report]
1Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Summary
A rare plunging ranula presented as a large retroauricular mass in a child, initially misdiagnosed. Complete sublingual gland removal successfully treated this unusual presentation.
Area of Science:
- Otolaryngology
- Pediatric Surgery
- Surgical Pathology
Background:
- Plunging ranulas are typically submandibular or submental cystic masses.
- They often lead to misdiagnosis due to their unusual presentation.
- This case highlights an atypical location for a plunging ranula.
Observation:
- A 6-year-old child presented with a recurrent, massive left retroauricular swelling and skin ulcers.
- Initial examination revealed a 5 cm fluctuant mass with thin, red skin and yellow, slime-like discharge.
- CT scan showed an extensive cystic lesion in the left neck.
Findings:
- The retroauricular mass was initially treated with incision and drainage, followed by resection misdiagnosed as a branchial cyst.
- Intraoperative findings traced a fistula to the sublingual gland.
- Postoperative discharge of "egg-white", wire-drawing fluid from the ear canal confirmed a plunging ranula originating from the sublingual gland.
Implications:
- This case demonstrates that plunging ranulas can occur in the retroauricular region, challenging conventional understanding.
- Accurate diagnosis requires considering radiographic imaging and analysis of cystic fluid.
- Complete excision of the ipsilateral sublingual gland is crucial for successful treatment and preventing recurrence.
