The ranula is a mucous extravasation phenomenon (mucocele) that occurs in the floor of the mouth. Disruption of the duct of either a sublingual gland or minor salivary gland results in mucous spillage.
Ranulas generally occur in the first two decades of life, with no particular sex predilection. They present as unilateral, bluish, dome-shaped, non-tender, fluctuant swellings in the floor of the mouth, although deeper lesions may be normal in color. Ranulas may reach several centimeters in diameter, filling the floor of the mouth and elevating the tongue.
Spilled mucin may dissect below the mylohyoid muscle and produce a swelling in the neck. This is referred to as the "plunging" or "cervical" ranula.
They may develop rapidly and be present for a few days with gradual increase in size.
Related topic: Oral mucocele
Ranula - Oral Mucosal Lesion
Alerts and Notices
Synopsis
Codes
ICD10CM:
K11.6 – Mucocele of salivary gland
SNOMEDCT:
14919007 – Ranula
K11.6 – Mucocele of salivary gland
SNOMEDCT:
14919007 – Ranula
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Differential Diagnosis & Pitfalls
- Benign mesenchymal neoplasms – Tumors such as lipoma, neurofibroma, or schwannoma could present as a swelling in the floor of the mouth, although these would be slow growing and not fluctuant.
- Salivary gland neoplasms – Most salivary gland neoplasms in the floor of the mouth are malignant. Low-grade mucoepidermoid carcinoma may have a bluish tinge, although this lesion will typically be firmer, have a longer duration, and have less-defined margins compared to the ranula.
- Dermoid or epidermoid cyst – These developmental cysts present as a non-tender swelling in floor of mouth. They have a doughy consistency but are not fluctuant.
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Last Updated:03/05/2018
Ranula - Oral Mucosal Lesion