Department of Gynecology, Félix Guyon Hospital, 97400 Saint-Denis, Ile de la Réunion, France.

Case report

This is a case of  a 30-year-old woman, G6 P5, who referred to our antenatal unit at 35 weeks of gestation due to a lingual cyst. The previous scans at 13 and 24 weeks were reported as normal. Patient had non-contributive personal or family history.

Our ultrasound exam showed that the fetal mouth was partially opened and oral cavity was filled with a cystic mass. Color Doppler showed blood flow within the solid part of the mass. The swallowing process was not affected. The stomach showed normal filling and there was a normal amount of the amniotic fluid. No other associated malformations were seen. 3D-ultrasound confirmed our findings. Cystic mass measured 20 x 18 mm.

Ultrasound follow-up in 1 week did not show any growth of the mass. No intra-cervical extension was noted. The fetal MRI detected the same findings.

After extensive counselling with pediatric and otorhinolaryngologist surgeon, the patient was reassured and continued in her pregnancy. An amniocentesis showed a normal karyotype.

The patient delivered in 39 weeks of gestation and the neonate suffered from respiratory distress after delivery. The neonate was intubated and the surgery was performed three days later. The cyst was removed and the final diagnosis according to the pathologist was a benign mucous cyst, oral ranula.

Mucous cysts are called ranula when they arise from the floor fo the mouth, and epulis when they arise from the gums.

Images 1,2: 35 weeks, Image 1 shows an opened mouth filled with mostly anechoic cystic mass. Image shows the cystic mass measuring 33 x 39 mm.