Mucoceles and ranulas
Mucoceles and ranulas are the same thing!
- a ranula is termed a mucous retention cyst and occurs in the floor of mouth is mor elikley due to obstruction
- a mucocele is termed a mucous extravasation cyst and occurs (usually in lower lip) in other salivary glands and is more likley due to trauma
Etiology and Pathophysiology
Mucoceles: often associated iwth a history of trauma, resulting in the leakage of fluid from the ducts or acini into the surrounding tissue Mucous retention cysts (Ranula): Typically caused by the obstruction of a duct rather than direct trauma
Contributory factors :
Trauma or obstruction
Prevalence
- Very common
- Especially in children and young adults due to higher rates of local trauma
Histological Features
Depends on if the lesion is intact or ruptured
- intact lesions
- Pseudocystic cavity containing mucus
- Presence of numerous foamy epithelial histioctyes (muciphages), neutrophils and granulation tissue
- No epithelial cystic lining; superficial oral mucosa may show variable atrophy in superficial mucoceles
- **Ruptured Lesions **
- Fragments of granulation tissue containing muciphages and neutrophils
- Visible mucinous material
- Associated salivary gland parenchyma may show obstructive changes, including acinar atrphy, ductal dilation with periductal hyalinization, interstitial lymphoplasmacytic infiltration and late-stage fibrosis
Clinical Features
Duration is variable and often dpeends on the level of inconvenience cause to the patient
Location
- Mucocele: mucosa or vermillion of the lower lip though can occur at other intraoral sites
- Ranula: floor of mouth
Appearance
- Color ranges from deep blue to normal pink
- commonly present as soft, painless swellings
Differential Diagnoses
- Fibroepithelial polyp/ traumatic fibroma
- Lipoma
- Venous malformation
Ranula specific:
- sialolithiasis
- Sialadenitis
- Vascular malformation
Relevant Clinical Investigations
- Biopsy
- Diascopy / blanching test
- Aspiration
- Ultrasound
Patient Management
Ranula:
- removal of the lesion by complete excision without rupture, including removal of the associated minor salivary glands