Diving ranula - through dehiscence

Case contributed by Frank Gaillard
Diagnosis almost certain
This study is a stack
Coronal C+
delayed
This study is a stack
Axial C+
delayed
This study is a stack
Sagittal
C+ delayed
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Info

CT of the floor of mouth in a patient with a left-sided swelling demonstrates a large rounded water density cystic mass located inferior to mylohyoid muscle. 

Anteriorly a small extension of the cyst can be traced through the muscle fibres into the sublingual space.

Features are consistent with a diving ranula.

Annotated image
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Info

Small extension into the sublingual space is the key to raise the possibility of a diving ranula.

Case Discussion

Final Diagnosis: 

Left submandibular gland excision:

  • A. Benign granulation tissue and sinus tract with abundant macrophages
  • B. Features are consistent with, but not diagnostic of, a plunging ranula
  • C. Benign lymph node
  • D. Unremarkable submandibular gland

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