Sudden appearance of a plunging ranula in a child: Atypical case report

A plunging ranula corresponds to an extravasation of saliva from the sublingual glands to the submandibular space and adjacent deep spaces. It is a very rare occurrence in children. Its management modalities are still controverted.

We report a rare case of a seven-year-old child with no known medical history who presented with a sudden swelling on the floor of the mouth without any triggering factor. Physical examination revealed a bluish painless swelling at the floor of the mouth, fluctuant at palpation. It was associated with submental and submandibular swelling. Cervical computed tomography showed a right-side plunging ranula measuring 6 cm, extended to the ipsilateral submandibular space and the contralateral sublingual space. Multiple aspirations were performed followed by incision and drainage under local anesthesia, which evacuated the cyst. The aspirates of the cyst had a very vicious consistency. After a follow-up period of one year, no recurrence was observed.

The diagnosis of plunging ranula is based on the clinical and radiological evaluation. Its management is still controverted; it is either conservative or surgical.

This study highlights a rare occurrence of a sudden appearance of a plunging ranula in a child to emphasize the importance of making the appropriate diagnosis and management modality.