PDF(Pubmed)
Abstract：
UNASSIGNED: A plunging ranula may present initially as an extensive vallecular cyst and correct diagnosis may be reached with the use of ultrasound, fluid aspiration for amylase detection, and MRI imaging.
UNASSIGNED: The ranula is a pseudocyst of the sublingual salivary gland and can be divided into two known subtypes. The simple ranula and plunging ranula. While the simple type can be found in the floor of the mouth, the plunging ranula usually pervades the mylohoid muscle and presents as a cervical swelling. The presented case should outline the difficulties in diagnostic and treatment of an uncommon expression of a mucocele above the mylohoid muscle without presenting either a cervical or an intraoral swelling, only extending towards the vallecula. We present a previously unreported clinical manifestation of a ranula of an 18-year old male, which extends posteriorly, remaining confined in the supramylohyoid muscle space. The cystic lesion protrudes in the oropharynx, and clinically appears as an extensive vallecular cyst. On magnetic resonance imaging the initial suspected diagnosis of a vallecular cyst was changed to the final diagnosis of a plunging ranula. The marsupialization of the cyst sac was performed. Outpatient follow-up revealed a persisting ostium, indicating a continuous extravasation of the sublingual gland. The present case report describes an unusual clinical presentation of a plunging ranula, remaining above the mylohyoid muscle and protruding into the oropharynx, misdirecting to the first suspected diagnosis of a vallecular cyst. The case highlights the useful contribution of the MRI imaging for differential diagnoses and the need for criteria to indicate further investigations.
UNASSIGNED: The ranula is a pseudocyst of the sublingual salivary gland and can be divided into two known subtypes. The simple ranula and plunging ranula. While the simple type can be found in the floor of the mouth, the plunging ranula usually pervades the mylohoid muscle and presents as a cervical swelling. The presented case should outline the difficulties in diagnostic and treatment of an uncommon expression of a mucocele above the mylohoid muscle without presenting either a cervical or an intraoral swelling, only extending towards the vallecula. We present a previously unreported clinical manifestation of a ranula of an 18-year old male, which extends posteriorly, remaining confined in the supramylohyoid muscle space. The cystic lesion protrudes in the oropharynx, and clinically appears as an extensive vallecular cyst. On magnetic resonance imaging the initial suspected diagnosis of a vallecular cyst was changed to the final diagnosis of a plunging ranula. The marsupialization of the cyst sac was performed. Outpatient follow-up revealed a persisting ostium, indicating a continuous extravasation of the sublingual gland. The present case report describes an unusual clinical presentation of a plunging ranula, remaining above the mylohyoid muscle and protruding into the oropharynx, misdirecting to the first suspected diagnosis of a vallecular cyst. The case highlights the useful contribution of the MRI imaging for differential diagnoses and the need for criteria to indicate further investigations.
摘要：
■最初可能会出现巨大的血管瘤，通过超声检查可以获得正确的诊断，用于淀粉酶检测的液体抽吸，和MRI成像。
■ranula是舌下唾液腺的假性囊肿，可分为两种已知的亚型。简单的ranula和暴跌的ranula。虽然简单的类型可以在嘴巴的地板上找到，俯冲的颈ranula通常遍布于Mylooid肌肉，并表现为宫颈肿胀。所介绍的病例应概述在不出现宫颈或口内肿胀的情况下，在诊断和治疗上的困难。只向瓦莱库拉延伸。我们提出了一个以前未报道的18岁男性ranula的临床表现，向后延伸，仍然局限在舌骨上肌间隙。囊性病变突出于口咽部,临床上表现为广泛的瓣膜囊肿。在磁共振成像中，最初的怀疑诊断为瓣膜囊肿的诊断被改为最终诊断为插入的ranula。进行了囊肿囊的袋化。门诊随访发现一个持续的口，指示舌下腺的持续外渗。本病例报告描述了一个不寻常的ranula暴跌的临床表现，保留在舌骨肌上方并伸入口咽部，误导了首次怀疑诊断的瓣膜囊肿。该病例强调了MRI成像对鉴别诊断的有用贡献，以及需要标准来指示进一步的研究。
■ranula是舌下唾液腺的假性囊肿，可分为两种已知的亚型。简单的ranula和暴跌的ranula。虽然简单的类型可以在嘴巴的地板上找到，俯冲的颈ranula通常遍布于Mylooid肌肉，并表现为宫颈肿胀。所介绍的病例应概述在不出现宫颈或口内肿胀的情况下，在诊断和治疗上的困难。只向瓦莱库拉延伸。我们提出了一个以前未报道的18岁男性ranula的临床表现，向后延伸，仍然局限在舌骨上肌间隙。囊性病变突出于口咽部,临床上表现为广泛的瓣膜囊肿。在磁共振成像中，最初的怀疑诊断为瓣膜囊肿的诊断被改为最终诊断为插入的ranula。进行了囊肿囊的袋化。门诊随访发现一个持续的口，指示舌下腺的持续外渗。本病例报告描述了一个不寻常的ranula暴跌的临床表现，保留在舌骨肌上方并伸入口咽部，误导了首次怀疑诊断的瓣膜囊肿。该病例强调了MRI成像对鉴别诊断的有用贡献，以及需要标准来指示进一步的研究。
