Submandibular ranula with aberrated skin tissue—a case report—

Abstract

A 1-year-old boy presented with a left submandibular mass which started to enlarge gradually from six months after birth. When he was first seen at the hospital, the mass showed an elastic soft tumor, 3cm in diameter, without signs of inflammation and tenderness. Ultrasonography revealed a cystic mass including a high echoic lesion inside. There were no findings in the oral cavity. We diagnosed the tumor as submandibular ranula. Needle puncture was unsuccessful because of viscous content. We injected OK-432 into the cyst after draining the transparent and gelatinous content from a small skin incision. The mass recurred two months later. As the former treatment was determined to be ineffective the cyst was removed surgically by collar incision. The mass was present close to the salivary glands and progressed toward the oral cavity. The cyst wall was thin without epithelial lining, but stratified squamous epithelium, keratinized substance and hair follicles were found in a small part of the cyst wall. The pathological diagnosis was dermoid cyst. In this case, the basic structure of the cyst was submandibular ranula and the skin tissue was considered to be an abberated origin.