Ranula. Clinical case presentation and literature review.
Description
Oral ranula is a reactive pathology of the major salivary glands of the floor of the mouth that develops as a consequence of obstruction or rupture of the main excretory duct, causing leakage and accumulation of secretions from the gland above the mylohyoid muscle, clinically it is of variable size, translucent or bluish in color and fluctuating on palpation. We present the case of a 62-year-old male patient who attended the Oral Medicine Clinic of the Dental School of UNPHU for treatment. On clinical examination, a papular lesion of rounded shape and translucent color, 4 mm in diameter, with fluctuating consistency and a pedunculated base located on the left side of the floor of the mouth was identified. The patient was referred to the Department of Oral Medicine and a clinical history was taken, in which the patient referred to previous episodes of sublingual calculus, with pain at the time of dislodgement, located in the left sublingual gland, where he subsequently presented a painless lesion that progressively increased in size. Imaging studies such as occlusal radiography and tomography were indicated. Based on the patient's history, a thorough clinical examination of the affected area, and the presence of visible calcified structures in the indicated additional studies, a presumptive diagnosis of oral ranula was made, and its surgical removal was indicated after preoperative hematologic studies. After surgery, the specimen was sent for its corresponding histopathologic study, which confirmed the clinical diagnosis of ranula or mucous retention cyst. In the postoperative controls a normal healing pattern was observed and 6 months later there is no evidence of recurrence of ranula. The case presents a typical manifestation of ranula caused by salivary retention due to duct obstruction, and surgical removal of the salivary gland associated with the ranula is the treatment of choice to avoid recurrence.
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A lesion provisionally diagnosed as ranula was clinically identified. An imaging study of occlusal and panoramic radiography and tomography showed multiple calcifications. After performing hematological studies, with results within normal parameters, it was decided to surgically remove the ranula and perform an excisional biopsy. The histopathological results confirmed the diagnosis of ranula.