A Rare Case of a Plunging Ranula in a 42-Year- Old Male Patient: A Case Report

Plunging ranulas are rare retention pseudocysts of the major salivary glands, most often of the sublingual gland, and usually occur in individuals from the first to the sixth decade of life with female predominance. Given their similar location and physical and imaging characteristics to thyroglossal cysts, distinguishing the two lesions is often a differential diagnostic dilemma even for the experienced physician. This case report presents a 42-year-old man for whom a preliminary diagnosis of a thyroglossal duct cyst was made based on a physical examination. A neck ultrasound was performed and the lesion was surgically excised. However, pathological analysis revealed a plunging ranula of a salivary gland. A contrast-enhanced computed tomography (CT) of the neck was performed. It showed close proximity of the lesion to the right sublingual salivary gland. Because of this, it was assumed that the gland was associated with the occurrence of his condition, and the patient was offered a complete sialoadenectomy. However, the patient refused this plan of treatment. Approximately seven months later there was a recurrence for which he was operated on again. Despite the warning of a high probability of recurrence, the patient categorically refused sialadenectomy.