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Ranula vs. Atypical Sublingual Branchial Cleft Cyst: A Case Report.

Saleh Mohebbi1, Fatemeh Abedin2, Sahar Zahedi2

  • 1Skull Base Research Center, School of Medicine Iran University of Medical Sciences Tehran Iran.

Clinical Case Reports
|April 13, 2026
PubMed
Summary
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This case report describes a rare congenital sublingual branchial cleft cyst in an infant, emphasizing the diagnostic challenges and the importance of complete surgical excision to prevent recurrence.

Area of Science:

  • Pediatric Surgery
  • Head and Neck Surgery
  • Developmental Biology

Background:

  • Congenital cystic lesions in the infant floor of the mouth pose diagnostic challenges due to similar clinical and radiological presentations.
  • Distinguishing these lesions from conditions like ranulas is crucial for appropriate management.

Purpose of the Study:

  • To report a rare case of an atypical sublingual branchial cleft cyst in an infant.
  • To highlight the diagnostic difficulties and the importance of complete surgical excision for such congenital anomalies.

Main Methods:

  • A case study of a one-year-old boy with a sublingual swelling is presented.
  • Clinical examination, contrast-enhanced computed tomography (CECT), and intraoperative findings were utilized.
  • Histopathological analysis confirmed the diagnosis after surgical excision.
Keywords:
branchial cleft cysthistopathologyneck massranulasurgerythyroglossal duct cyst

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Main Results:

  • Histopathology revealed a cyst lined by respiratory and squamous epithelium, consistent with an atypical branchial cleft cyst with a sinus tract.
  • The lesion was successfully excised via an intraoral approach, and no recurrence was observed at six-month follow-up.
  • Preoperative imaging limitations in differentiating ranula from branchial anomalies were noted.

Conclusions:

  • Atypical branchial cleft cysts presenting as isolated sublingual cysts are rare in infants.
  • Complete surgical excision, including associated sinus tracts, is essential for preventing recurrence.
  • This case underscores the diagnostic challenges in pediatric floor of mouth cystic lesions.