Mucingranula

Mucingranula is a rare benign lesion of the oral mucosa that is considered a mucous cyst related to salivary glands. It is often described as a ranula-like lesion arising from the sublingual or other minor salivary glands and presenting as a soft, fluctuant swelling in the floor of the mouth or beneath the tongue.

Clinical features typically include a painless, slowly enlarging swelling that may cause discomfort, speech or swallowing difficulties if large. Because it is located in the floor of the mouth, clinicians may observe elevation of the tongue and potential airway concerns in very large lesions.

Diagnosis is based on clinical examination supported by imaging when needed. Ultrasound or magnetic resonance imaging can help assess size, extent, and involvement of the sublingual gland or surrounding structures. Histologic evaluation of excised tissue shows features consistent with an extravasation-type mucocele: mucin deposited in the connective tissue with granulation tissue and inflammatory cells and no true epithelial lining.

Differential diagnosis includes other cystic or vascular lesions of the floor of the mouth, such as other mucoceles, ranulas, cystic odontogenic lesions, or lymphatic malformations.

Treatment commonly involves surgical excision of the lesion with removal of the involved salivary gland to reduce recurrence. Marsupialization or simple aspiration alone has a higher risk of recurrence. Complete excision typically yields a good prognosis.

See also: mucocele, ranula, salivary gland disorders.