Simple: True cyst confined to sublingual space (SLS)
Diving: Extravasation pseudocyst; ruptured SR extending into submandibular space (SMS)
Term ranula derives from Latin "rana," meaning "frog"
Sublingual blebs in mouth of frog resemble SR
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Borkar NB et al: A rare case of congenital ranula. Afr J Paediatr Surg. 18(2):106-8, 2021
Chen JX et al: Sublingual gland excision for the surgical management of plunging ranula. Am J Otolaryngol. 39(5):497-500, 2018
Harrison JD: The pathophysiological basis and surgical management of ranula are established. World J Surg. 42(4):1208-9, 2018
Lomas J et al: Surgical management of plunging ranulas: a 10-year case series in South East Queensland. ANZ J Surg. 88(10):1043-6, 2018
Pontes FSC et al: Congenital ranula: a case report and literature review. J Clin Pediatr Dent. 42(6):454-7, 2018
Sousa Melo SL et al: Mucoepidermoid carcinoma mimicking a mucocele (ranula) in the floor of the mouth. Dentomaxillofac Radiol. 47(4):20170331, 2018
Abt NB et al: Plunging ranula with prestyloid parapharyngeal space, masticator space, and parotid gland extension. B-ENT. 13(1 Suppl 27):57-60, 2017
Katabi N et al: Update from the 4th edition of the World Health Organization classification of head and neck tumours: what is new in the 2017 WHO Blue Book for tumors and tumor-like lesions of the neck and lymph nodes. Head Neck Pathol. 11(1):48-54, 2017
Kokong D et al: Ranula: current concept of pathophysiologic basis and surgical management options. World J Surg. 41(6):1476-81, 2017
Lyly A et al: Plunging ranula - patient characteristics, treatment, and comparison between different populations. Acta Otolaryngol. 137(12):1271-4, 2017
Shah Arpan K et al: Plunging ranula occurring without its oral counterpart: a case report. J Clin Pediatr Dent. 41(5):381-3, 2017
Lee JY et al: Plunging ranulas revisited: a CT study with emphasis on a defect of the mylohyoid muscle as the primary route of lesion propagation. Korean J Radiol. 17(2):264-70, 2016
Margalit I et al: Point-of-care ultrasound to diagnose a simple ranula. West J Emerg Med. 17(6):827-8, 2016
Chen CJ et al: Recurrent sublingual ranula or saliva leakage from the submandibular gland? Anatomical consideration of the ductal system of the sublingual gland. J Oral Maxillofac Surg. 73(4):675.e1-7, 2015
Heller M et al: Hemorrhagic transformation of a plunging ranula: an unusual cause of a rapidly enlarging neck mass. Am J Emerg Med. 33(4):597.e3-4, 2015
Jia T et al: Minimally invasive treatment of oral ranula with a mucosal tunnel. Br J Oral Maxillofac Surg. 53(2):138-41, 2015
Lee DH et al: Treatment outcomes of the intraoral approach for a simple ranula. Oral Surg Oral Med Oral Pathol Oral Radiol. 119(4):e223-5, 2015
Owens DJ et al: Orthodontics: a traumatic cause of ranula. Br Dent J. 219(5):194-5, 2015
Sathanantham DK et al: Rapid development of a simple ranula in a child. Ann Otol Rhinol Laryngol. 124(4):322-5, 2015
Syebele K et al: Oral mucocele/ranula: another human immunodeficiency virus-related salivary gland disease? Laryngoscope. 125(5):1130-6, 2015
Truong K et al: Value of sialendoscopy-assisted transoral sublingual gland resection for a plunging ranula: case report and review. J Laryngol Otol. 129(5):509-12, 2015
Garofalo S et al: Successful medical treatment for ranula in children. Oral Surg Oral Med Oral Pathol Oral Radiol. 117(4):e289-97, 2014
Li J et al: Correct diagnosis for plunging ranula by magnetic resonance imaging. Aust Dent J. 59(2):264-7, 2014
Mabongo M et al: Plunging ranula: an unusual multilocular presentation. SADJ. 69(9):416-8, 2014
Mun SJ et al: Ductal variation of the sublingual gland: a predisposing factor for ranula formation. Head Neck. 36(4):540-4, 2014
Yang Y et al: Surgical results of the intraoral approach for plunging ranula. Acta Otolaryngol. 134(2):201-5, 2014
Al Ruhaimi KA: Recurrent plunging ranula of the neck. Saudi Med J. 34(3):313-5, 2013
Alves TP et al: Successful management of oral ranula: a rare case in an infant. Gen Dent. 61(3):26-8, 2013
de Santana Santos T et al: Excision of ranula using injection of hydrocolloid dental impression material. J Craniofac Surg. 24(5):1859-60, 2013
Fontenot TE et al: Swelling of submandibular region. Plunging ranula. JAMA Otolaryngol Head Neck Surg. 139(10):1073-4, 2013
Harrison JD et al: Postmortem investigation of mylohyoid hiatus and hernia: aetiological factors of plunging ranula. Clin Anat. 26(6):693-9, 2013
Lesperance MM: When do ranulas require a cervical approach? Laryngoscope. 123(8):1826-7, 2013
McKinstry S et al: Bilateral plunging ranula: two case reports and a review of the literature. N Z Med J. 126(1385):81-6, 2013
Nikitakis NG et al: Asymptomatic swelling in the floor of the mouth. Salivary duct cyst (ranula). Gen Dent. 61(1):77- 8, 2013
O'Connor R et al: The plunging ranula: diagnostic difficulties and a less invasive approach to treatment. Int J Oral Maxillofac Surg. 42(11):1469-74, 2013
Saji N et al: A case of impaired tongue movement in an elderly person. Diagnosis: Sublingual ranula. Eur Neurol. 70(5-6):329-30, 2013
Sigismund PE et al: Management of ranula: 9 years' clinical experience in pediatric and adult patients. J Oral Maxillofac Surg. 71(3):538-44, 2013
Syebele K et al: The potential impact of highly active antiretroviral therapy on the treatment and epidemiology of ranula in human immunodeficiency virus-positive patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 116(1):e32-6, 2013
Darwish C et al: A clinico-pathologic correlation. Oral ranula. J Mass Dent Soc. 61(1):40-2, 2012
Effat KG: Acute presentation of a plunging ranula causing respiratory distress: case report. J Laryngol Otol. 126(8):861-3, 2012
Hernandez-Martin A et al: Images in clinical medicine. Ranula. N Engl J Med. 367(26):e38, 2012
Hze-Khoong EP et al: Submandibular gland mucocele associated with a mixed ranula. Oral Surg Oral Med Oral Pathol Oral Radiol. 113(6):e6-9, 2012
Jain R et al: Diagnostic difficulties of plunging ranula: case series. J Laryngol Otol. 126(5):506-10, 2012
Kinoshita M et al: Plunging ranula intruding into the parapharyngeal space treated with OK-432. Am J Otolaryngol. 33(3):345-8, 2012
Kinshuck AJ et al: Oral ranula in an HIV-positive patient: case report and literature review. BMJ Case Rep. 2012, 2012
Thimann D et al: Images in emergency medicine. 10-year-old female with a subglottic mass. Ranula. Ann Emerg Med. 60(5):668, 677, 2012
Jia Y et al: Clinical and histopathological review of 229 cases of ranula. J Huazhong Univ Sci Technolog Med Sci. 31(5):717-20, 2011
Samant S et al: Surgery for plunging ranula: the lesson not yet learned? Eur Arch Otorhinolaryngol. 268(10):1513-8, 2011
Harrison JD: Modern management and pathophysiology of ranula: Literature review. Head Neck. 32(10):1310-20, 2010
Jain P et al: Plunging ranulas: high-resolution ultrasound for diagnosis and surgical management. Eur Radiol. 20(6):1442-9, 2010
Clyburn VL 3rd et al: Ascending and plunging ranula in a pediatric patient. Otolaryngol Head Neck Surg. 140(6):948-9, 2009
Lai JB et al: Treatment of ranula using carbon dioxide laser--case series report. Int J Oral Maxillofac Surg. 38(10):1107-11, 2009
Patel MR et al: Oral and plunging ranulas: what is the most effective treatment? Laryngoscope. 119(8):1501-9, 2009
Zhi K et al: Management of the pediatric plunging ranula: results of 15 years' clinical experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 107(4):499-502, 2009
Roh JL et al: Primary treatment of pediatric plunging ranula with nonsurgical sclerotherapy using OK-432 (Picibanil). Int J Pediatr Otorhinolaryngol. 72(9):1405-10, 2008
Rosa PA et al: Congenital neck masses. Oral Maxillofac Surg Clin North Am. 20(3):339-52, 2008
Rho MH et al: OK-432 sclerotherapy of plunging ranula in 21 patients: it can be a substitute for surgery. AJNR Am J Neuroradiol. 27(5):1090-5, 2006
Haberal I et al: Surgical management of pediatric ranula. Int J Pediatr Otorhinolaryngol. 68(2):161-3, 2004
Choi TW et al: Hydrodissection for complete removal of a ranula. Ear Nose Throat J. 82(12):946-7, 951, 2003
Fukase S et al: Treatment of ranula wth intracystic injection of the streptococcal preparation OK-432. Ann Otol Rhinol Laryngol. 112(3):214-20, 2003
Macdonald AJ et al: Giant ranula of the neck: differentiation from cystic hygroma. AJNR Am J Neuroradiol. 24(4):757-61, 2003
Onderoglu L et al: Prenatal diagnosis of ranula at 21 weeks of gestation. Ultrasound Obstet Gynecol. 22(4):399-401, 2003
Takagi S et al: Treatment of a plunging ranula with fenestration and continuous pressure. Br J Oral Maxillofac Surg. 41(6):410-3, 2003
Woo JS et al: Recurrent plunging ranula treated with OK-432. Eur Arch Otorhinolaryngol. 260(4):226-8, 2003
Pandit RT et al: Management of pediatric ranula. Otolaryngol Head Neck Surg. 127(1):115-8, 2002
Baurmash HD: Treating oral ranula: another case against blanket removal of the sublingual gland. Br J Oral Maxillofac Surg. 39(3):217-20, 2001
White DK et al: Accessory salivary tissue in the mylohyoid boutonnière: a clinical and radiologic pseudolesion of the oral cavity. AJNR Am J Neuroradiol. 22(2):406-12, 2001
Kurabayashi T et al: MRI of ranulas. Neuroradiology. 42(12):917-22, 2000
Davison MJ et al: Plunging ranula: clinical observations. Head Neck. 20(1):63-8, 1998
Fernandez Moya JM et al: Antenatal diagnosis and management of a ranula. Ultrasound Obstet Gynecol. 11(2):147-8, 1998
Ichimura K et al: Surgical management of the plunging ranula: a review of seven cases. J Laryngol Otol. 110(6):554-6, 1996
Yoshimura Y et al: A comparison of three methods used for treatment of ranula. J Oral Maxillofac Surg. 53(3):280-2; discussion 283, 1995
Coit WE et al: Ranulas and their mimics: CT evaluation. Radiology. 163(1):211-6, 1987
Simple: True cyst confined to sublingual space (SLS)
Diving: Extravasation pseudocyst; ruptured SR extending into submandibular space (SMS)
Term ranula derives from Latin "rana," meaning "frog"
Sublingual blebs in mouth of frog resemble SR
IMAGING
General Features
CT Findings
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
Staging, Grading, & Classification
Gross Pathologic & Surgical Features
Microscopic Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Borkar NB et al: A rare case of congenital ranula. Afr J Paediatr Surg. 18(2):106-8, 2021
Chen JX et al: Sublingual gland excision for the surgical management of plunging ranula. Am J Otolaryngol. 39(5):497-500, 2018
Harrison JD: The pathophysiological basis and surgical management of ranula are established. World J Surg. 42(4):1208-9, 2018
Lomas J et al: Surgical management of plunging ranulas: a 10-year case series in South East Queensland. ANZ J Surg. 88(10):1043-6, 2018
Pontes FSC et al: Congenital ranula: a case report and literature review. J Clin Pediatr Dent. 42(6):454-7, 2018
Sousa Melo SL et al: Mucoepidermoid carcinoma mimicking a mucocele (ranula) in the floor of the mouth. Dentomaxillofac Radiol. 47(4):20170331, 2018
Abt NB et al: Plunging ranula with prestyloid parapharyngeal space, masticator space, and parotid gland extension. B-ENT. 13(1 Suppl 27):57-60, 2017
Katabi N et al: Update from the 4th edition of the World Health Organization classification of head and neck tumours: what is new in the 2017 WHO Blue Book for tumors and tumor-like lesions of the neck and lymph nodes. Head Neck Pathol. 11(1):48-54, 2017
Kokong D et al: Ranula: current concept of pathophysiologic basis and surgical management options. World J Surg. 41(6):1476-81, 2017
Lyly A et al: Plunging ranula - patient characteristics, treatment, and comparison between different populations. Acta Otolaryngol. 137(12):1271-4, 2017
Shah Arpan K et al: Plunging ranula occurring without its oral counterpart: a case report. J Clin Pediatr Dent. 41(5):381-3, 2017
Lee JY et al: Plunging ranulas revisited: a CT study with emphasis on a defect of the mylohyoid muscle as the primary route of lesion propagation. Korean J Radiol. 17(2):264-70, 2016
Margalit I et al: Point-of-care ultrasound to diagnose a simple ranula. West J Emerg Med. 17(6):827-8, 2016
Chen CJ et al: Recurrent sublingual ranula or saliva leakage from the submandibular gland? Anatomical consideration of the ductal system of the sublingual gland. J Oral Maxillofac Surg. 73(4):675.e1-7, 2015
Heller M et al: Hemorrhagic transformation of a plunging ranula: an unusual cause of a rapidly enlarging neck mass. Am J Emerg Med. 33(4):597.e3-4, 2015
Jia T et al: Minimally invasive treatment of oral ranula with a mucosal tunnel. Br J Oral Maxillofac Surg. 53(2):138-41, 2015
Lee DH et al: Treatment outcomes of the intraoral approach for a simple ranula. Oral Surg Oral Med Oral Pathol Oral Radiol. 119(4):e223-5, 2015
Owens DJ et al: Orthodontics: a traumatic cause of ranula. Br Dent J. 219(5):194-5, 2015
Sathanantham DK et al: Rapid development of a simple ranula in a child. Ann Otol Rhinol Laryngol. 124(4):322-5, 2015
Syebele K et al: Oral mucocele/ranula: another human immunodeficiency virus-related salivary gland disease? Laryngoscope. 125(5):1130-6, 2015
Truong K et al: Value of sialendoscopy-assisted transoral sublingual gland resection for a plunging ranula: case report and review. J Laryngol Otol. 129(5):509-12, 2015
Garofalo S et al: Successful medical treatment for ranula in children. Oral Surg Oral Med Oral Pathol Oral Radiol. 117(4):e289-97, 2014
Li J et al: Correct diagnosis for plunging ranula by magnetic resonance imaging. Aust Dent J. 59(2):264-7, 2014
Mabongo M et al: Plunging ranula: an unusual multilocular presentation. SADJ. 69(9):416-8, 2014
Mun SJ et al: Ductal variation of the sublingual gland: a predisposing factor for ranula formation. Head Neck. 36(4):540-4, 2014
Yang Y et al: Surgical results of the intraoral approach for plunging ranula. Acta Otolaryngol. 134(2):201-5, 2014
Al Ruhaimi KA: Recurrent plunging ranula of the neck. Saudi Med J. 34(3):313-5, 2013
Alves TP et al: Successful management of oral ranula: a rare case in an infant. Gen Dent. 61(3):26-8, 2013
de Santana Santos T et al: Excision of ranula using injection of hydrocolloid dental impression material. J Craniofac Surg. 24(5):1859-60, 2013
Fontenot TE et al: Swelling of submandibular region. Plunging ranula. JAMA Otolaryngol Head Neck Surg. 139(10):1073-4, 2013
Harrison JD et al: Postmortem investigation of mylohyoid hiatus and hernia: aetiological factors of plunging ranula. Clin Anat. 26(6):693-9, 2013
Lesperance MM: When do ranulas require a cervical approach? Laryngoscope. 123(8):1826-7, 2013
McKinstry S et al: Bilateral plunging ranula: two case reports and a review of the literature. N Z Med J. 126(1385):81-6, 2013
Nikitakis NG et al: Asymptomatic swelling in the floor of the mouth. Salivary duct cyst (ranula). Gen Dent. 61(1):77- 8, 2013
O'Connor R et al: The plunging ranula: diagnostic difficulties and a less invasive approach to treatment. Int J Oral Maxillofac Surg. 42(11):1469-74, 2013
Saji N et al: A case of impaired tongue movement in an elderly person. Diagnosis: Sublingual ranula. Eur Neurol. 70(5-6):329-30, 2013
Sigismund PE et al: Management of ranula: 9 years' clinical experience in pediatric and adult patients. J Oral Maxillofac Surg. 71(3):538-44, 2013
Syebele K et al: The potential impact of highly active antiretroviral therapy on the treatment and epidemiology of ranula in human immunodeficiency virus-positive patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 116(1):e32-6, 2013
Darwish C et al: A clinico-pathologic correlation. Oral ranula. J Mass Dent Soc. 61(1):40-2, 2012
Effat KG: Acute presentation of a plunging ranula causing respiratory distress: case report. J Laryngol Otol. 126(8):861-3, 2012
Hernandez-Martin A et al: Images in clinical medicine. Ranula. N Engl J Med. 367(26):e38, 2012
Hze-Khoong EP et al: Submandibular gland mucocele associated with a mixed ranula. Oral Surg Oral Med Oral Pathol Oral Radiol. 113(6):e6-9, 2012
Jain R et al: Diagnostic difficulties of plunging ranula: case series. J Laryngol Otol. 126(5):506-10, 2012
Kinoshita M et al: Plunging ranula intruding into the parapharyngeal space treated with OK-432. Am J Otolaryngol. 33(3):345-8, 2012
Kinshuck AJ et al: Oral ranula in an HIV-positive patient: case report and literature review. BMJ Case Rep. 2012, 2012
Thimann D et al: Images in emergency medicine. 10-year-old female with a subglottic mass. Ranula. Ann Emerg Med. 60(5):668, 677, 2012
Jia Y et al: Clinical and histopathological review of 229 cases of ranula. J Huazhong Univ Sci Technolog Med Sci. 31(5):717-20, 2011
Samant S et al: Surgery for plunging ranula: the lesson not yet learned? Eur Arch Otorhinolaryngol. 268(10):1513-8, 2011
Harrison JD: Modern management and pathophysiology of ranula: Literature review. Head Neck. 32(10):1310-20, 2010
Jain P et al: Plunging ranulas: high-resolution ultrasound for diagnosis and surgical management. Eur Radiol. 20(6):1442-9, 2010
Clyburn VL 3rd et al: Ascending and plunging ranula in a pediatric patient. Otolaryngol Head Neck Surg. 140(6):948-9, 2009
Lai JB et al: Treatment of ranula using carbon dioxide laser--case series report. Int J Oral Maxillofac Surg. 38(10):1107-11, 2009
Patel MR et al: Oral and plunging ranulas: what is the most effective treatment? Laryngoscope. 119(8):1501-9, 2009
Zhi K et al: Management of the pediatric plunging ranula: results of 15 years' clinical experience. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 107(4):499-502, 2009
Roh JL et al: Primary treatment of pediatric plunging ranula with nonsurgical sclerotherapy using OK-432 (Picibanil). Int J Pediatr Otorhinolaryngol. 72(9):1405-10, 2008
Rosa PA et al: Congenital neck masses. Oral Maxillofac Surg Clin North Am. 20(3):339-52, 2008
Rho MH et al: OK-432 sclerotherapy of plunging ranula in 21 patients: it can be a substitute for surgery. AJNR Am J Neuroradiol. 27(5):1090-5, 2006
Haberal I et al: Surgical management of pediatric ranula. Int J Pediatr Otorhinolaryngol. 68(2):161-3, 2004
Choi TW et al: Hydrodissection for complete removal of a ranula. Ear Nose Throat J. 82(12):946-7, 951, 2003
Fukase S et al: Treatment of ranula wth intracystic injection of the streptococcal preparation OK-432. Ann Otol Rhinol Laryngol. 112(3):214-20, 2003
Macdonald AJ et al: Giant ranula of the neck: differentiation from cystic hygroma. AJNR Am J Neuroradiol. 24(4):757-61, 2003
Onderoglu L et al: Prenatal diagnosis of ranula at 21 weeks of gestation. Ultrasound Obstet Gynecol. 22(4):399-401, 2003
Takagi S et al: Treatment of a plunging ranula with fenestration and continuous pressure. Br J Oral Maxillofac Surg. 41(6):410-3, 2003
Woo JS et al: Recurrent plunging ranula treated with OK-432. Eur Arch Otorhinolaryngol. 260(4):226-8, 2003
Pandit RT et al: Management of pediatric ranula. Otolaryngol Head Neck Surg. 127(1):115-8, 2002
Baurmash HD: Treating oral ranula: another case against blanket removal of the sublingual gland. Br J Oral Maxillofac Surg. 39(3):217-20, 2001
White DK et al: Accessory salivary tissue in the mylohyoid boutonnière: a clinical and radiologic pseudolesion of the oral cavity. AJNR Am J Neuroradiol. 22(2):406-12, 2001
Kurabayashi T et al: MRI of ranulas. Neuroradiology. 42(12):917-22, 2000
Davison MJ et al: Plunging ranula: clinical observations. Head Neck. 20(1):63-8, 1998
Fernandez Moya JM et al: Antenatal diagnosis and management of a ranula. Ultrasound Obstet Gynecol. 11(2):147-8, 1998
Ichimura K et al: Surgical management of the plunging ranula: a review of seven cases. J Laryngol Otol. 110(6):554-6, 1996
Yoshimura Y et al: A comparison of three methods used for treatment of ranula. J Oral Maxillofac Surg. 53(3):280-2; discussion 283, 1995
Coit WE et al: Ranulas and their mimics: CT evaluation. Radiology. 163(1):211-6, 1987
STATdx includes over 200,000 searchable images, including x-ray, CT, MR, and ultrasound images. To access all images, please log in or subscribe.