Ranula. Clinical case presentation and literature review.
Description
Oral ranula is a reactive pathology of the major salivary glands located in the floor of the mouth. It 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 presents as a variable-sized, translucent or bluish mass that fluctuates on palpation. We present the case of a 62 year-old male patient who attended for comprehensive care at the School of Dentistry of the UNPHU. On clinical examination a papular lesion of rounded shape and translucent color of 4 mm in diameter, with fluctuating consistency and pedunculated base located on the left side of the floor of the mouth was identified. The patient is referred to the Oral Medicine area and the clinical history is filled out in which the patient refers previous episodes of sublingual calculus, in which he presented pain at the moment of its release and later he presented a painless lesion that was progressively increasing in size. Imaging studies such as occlusal radiography and tomographic image were indicated. A large sialolith was identified in the images in the right submandibular gland, on the side opposite to the identified lesion. After the anamnesis, the exhaustive clinical examination of the affected area and the presence of visible calcified structures in the indicated complementary studies, the presumptive diagnosis of oral ranula associated with sialolithiasis was established, so its surgical removal was indicated after pre-surgical hematological studies. After surgery, the sample is sent to the corresponding histopathological study, which confirms the clinical diagnosis of ranula or mucous retention cyst. A normal healing pattern was observed in the postoperative controls, and 6 months later there is no evidence of recurrence of ranula. In order to avoid recurrence, the patient was referred to the Oncology Institute Dr. Heriberto Pieter, where he underwent the surgical procedure of submandibular sialoadenectomy, which consists in the removal of the gland. The case represents a typical manifestation of ranula caused by salivary retention due to ductal obstruction, and surgical removal of the salivary gland associated with the ranula is the treatment of choice to prevent recurrence.
Files
Steps to reproduce
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. 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. Patient was then referred for definitive treatment with submandibular salivary gland removal.