Intra oral swelling in a nine year old child

A 9-year-old female patient presented with a chief complaint of swelling in the floor of the mouth for the past 3 months. The swelling was initially small in size & gradually increased in size to attain the present size. The child gives a history of trauma to the mouth 3 months back. The swelling was not associated with any pain but the child had difficulty in speech, mastication & swallowing.

Parents consulted a doctor for the above complaint and were prescribed medicines which did not subside.

Intraoral examination

A single dome-shaped well-circumscribed swelling with a smooth surface, measuring approx 3 x 3 cm, bluish in color was present in the floor of the mouth pushing the tongue backward. On palpation, the swelling was nontender, fluctuant, noncompressible. There was no evidence of blanching and the swelling did not empty on compression.

Questions

  1. What is your probable clinical diagnosis?
Malignancy
Ranula
Submandibular Sialadenitis
Ludwing's Angina

Explanation

The probable clinical diagnosis is “Ranula”.

There are various etiological factors that have been attributed to the pathogenesis of ranula but the most accepted one is that it is mainly due to the trauma – direct trauma or from surgery to the floor of the mouth. In this, there is a rupture of the excretory duct resulting in extravasation of mucous in surrounding tissue leading to the formation of a pseudocyst.

You can read more about clinical presentation, Investigations, and treatment of Ranula from here.

Meet the author

Dr Sanu P Moideen is an Indian-born oto-rhino-laryngologist (ENT) based in Cochin, Kerala, India. He is currently working as Post-Doctoral Fellow in Head and Neck Oncology at Regional Cancer Center, Trivandrum, Kerala.

Read more

Comments & DIscussions

Your email address will not be published. Required fields are marked *