OK-432 Sclerotherapy of Plunging Ranula in 21 Patients: It Can Be a Substitute for Surgery
M.H. Rhoa,
D.W. Kima,
J.S. Kwona,
S.W. Leea,
Y.S. Sunga,
Y.K. Songa,
M.G. Kimb and
S.G. Kimb
a Department of Radiology, Masan Samsung Hospital, Sungkunkwan University School of Medicine, Masan, Korea
b Department of Otorhinolaryngology-Head and Neck Surgery, Masan Samsung Hospital, Sungkunkwan University School of Medicine, Masan, Korea
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Fig 1. Case 18. A 29-year-old man with severe left submandibular swelling shows total shrinkage after a single OK-432 injection.
A and B, Initial contrast-enhanced CT scan shows a large plunging ranula in the left sublingual (arrows) and submandibular spaces (arrowheads) with extending to the upper neck.
C and D, Follow-up postcontrast CT scan obtained 6 months after OK-432 sclerotherapy depicts total shrinkage of the plunging ranula.
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Fig 2. Case 1. A 21-year-old woman with a slow-growing mass in the right sublingual area shows near-total shrinkage after a single OK-432 injection.
A, Contrast-enhanced CT scan shows a large cystic lesion (arrows) in the right submandibular space.
B, Follow-up CT scan obtained 2 months after OK-432 sclerotherapy shows nearly total shrinkage of the plunging ranula (arrows).
C, Follow-up sonogram obtained 43 months after OK-432 sclerotherapy shows 2 small residual cystic lesions (arrows) in the right submandibular space. They represent less than 5% of the original volume of the cyst.
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Fig 3. Case 2. A 24-year-old man with tender swelling in the right submandibular area shows marked shrinkage after 2 OK-432 injections.
A, Contrast-enhanced CT scan shows a plunging ranula in the right submandibular space (arrows).
B, Contrast-enhanced CT scan obtained 2 months after the first sclerotherapy shows near total shrinkage of the plunging ranula (arrow), but the 3-month follow-up sonogram showed enlargement of the cyst.
C, Unenhanced CT scan obtained 3 years after the second injection shows marked shrinkage of the cyst (which was larger than after first injection) (arrow).
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Fig 4. Case 3. A 10-year-old boy with sublingual swelling shows partial shrinkage after 3 OK-432 injections.
A and B, The initial contrast-enhanced CT scan shows cystic lesions in the right sublingual space (arrows) and submental space (arrowheads).
C and D, Unenhanced CT scan taken 2 months after the first sclerotherapy, depicts disappearance of the cyst in the right sublingual space (arrow), but a cyst remains in the submental space (arrowheads). The ranula in the submental space recurred after its complete shrinkage after the next 2 OK-432 injections.
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Fig 5. Case 13. A 20-year-old man with tender swelling in the left submandibular area.
A and B, Initial enhanced CT scan shows multilocular, rim-enhancing cystic lesions in the right sublingual and submandibular space (arrows) with adjacent soft tissue infiltration and swelling (arrowheads). This abscess-like lesion was drained by pigtail catheter for 5 days. OK-432 sclerotherapy was performed 10 days after the pigtail catheter drainage of the plunging ranula.
C and D, Follow-up transverse and longitudinal sonograms obtained 11 months after OK-432 sclerotherapy shows complete shrinkage of the cystic lesion in the right sublingual space (arrowheads) and submandibular space (arrows).
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