Title: Management of Ranula in Primary Care
Authors: Dr Juan Toral Sanchez, Dr Ahmed Hassan
DOI: https://dx.doi.org/10.18535/jmscr/v14i01.06
Abstract
Introduction: A ranula is a benign mucous cyst arising from the sublingual gland. Although it is not a common lesion—particularly in children, where infectious processes are frequent—it can easily be mistaken for lymphadenopathy. Early recognition in Primary Care prevents unnecessary treatments and reassures families.
Case Presentation: An 8‑year‑old boy attended the Primary Care clinic because his mother had noticed a small lump under the mandible three days earlier. Initially, she did not pay much attention, as the patient had recently suffered from a common cold and she assumed it was an enlarged lymph node. Neck examination was normal. On oral inspection, the physician observed a translucent, fluctuant lesion on the floor of the mouth, consistent with a simple ranula. The child was asymptomatic. He was referred to ENT for further evaluation.
Discussion: Ranulas may resemble other common pediatric conditions, leading to misdiagnosis and inappropriate use of treatments, particularly antibiotics. Careful oral cavity examination is essential. The family physician plays a key role in recognizing these lesions and guiding families appropriately.
Conclusion: Ranula should be included in the differential diagnosis of sublingual or submandibular masses in children. A thorough oral examination in Primary Care can prevent diagnostic errors and facilitate appropriate management.
Keywords: ranula, mucocele, pediatric oral lesions, primary care, sublingual gland
References
- Baurmash HD. Mucoceles and ranulas. J Oral Maxillofac Surg. 2003;61(3):369‑78.
- Zhao YF, Jia Y, Chen XM, Zhang WF. Clinical review of 580 ranulas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;98(3):281‑7.
- Harrison JD. Modern management and pathophysiology of ranula: literature review. Head Neck. 2010;32(10):1310‑20.
- Patel MR, Deal AM, Shockley WW. Oral and plunging ranulas: what is the most effective treatment? Laryngoscope. 2009;119(8):1501‑9.
- Morton RP, Bartley JR. Simple ranulas: pathogenesis, diagnosis and management. Aust N Z J Surg. 1995;65(7):469‑73.
- Kurabayashi T, Ida M, Yasumoto M, et al. MRI of ranulas. Neuroradiology. 2000;42(11):917‑22.
- Zhi K, Wen Y, Ren W. Management of pediatric ranula. Int J Pediatr Otorhinolaryngol. 2009;73(7):923‑6.