Ranula — ORE Part 1 MCQ

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ModerateOral PathologyRanulaORE Part 1

A 40-year-old man presents with a unilateral swelling in the floor of his mouth. It is soft, fluctuant, and has a bluish hue. The swelling displaces the tongue. What is the most likely diagnosis?

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Correct answer: E — Ranula

The correct answer is E: Ranula. A ranula is a bluish, transparent, cystic swelling of the floor of the mouth arising from extravasation and accumulation of saliva from the sublingual gland. The classic presentation includes unilateral location, painless soft mass, characteristic bluish translucent appearance, and displacement of the tongue. This presentation is pathognomonic for ranula. Dermoid cysts are congenital midline lesions, not typically unilateral in the floor of mouth. Ludwig angina presents acutely with pain, tenderness, and signs of cellulitis, not a painless fluctuant swelling. Sublingual salivary gland tumours would present as firm masses without the translucent blue appearance. Thyroglossal duct cysts are midline lesions arising from the thyroglossal duct remnant, not lateral floor of mouth lesions.

Reference: Plunging Ranula: a Case Report. PubMed Central, 2013. https://pubmed.ncbi.nlm.nih.gov/23525726/; Modern management and pathophysiology of ranula: literature review. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 2010. https://pubmed.ncbi.nlm.nih.gov/20054853/