Clinical Diagnosis and Management of Bilateral Plunging Ranula.

Ranula is a benign salivary gland lesion originating from the sublingual salivary gland. This condition is primarily associated with salivary extravasation and retention due to obstruction or injury of the submandibular duct. A plunging ranula represents a rare variant occurring in the neck, submandibular, or submental regions, with bilateral presentations being particularly uncommon. Clinically, due to its lack of specificity, it is easily confused with other cervical lesions. This paper reports a case of a 25-year-old female presenting with bilateral painless submandibular masses. MRI revealed the characteristic bilateral "drooping tail sign". Following bilateral sublingual gland and cyst excision, the patient recovered well postoperatively with no immediate complications. At the two-month follow-up, no recurrence was observed, and symptoms were completely resolved. This paper aims to summarize the imaging features of bilateral plunging ranula and enhance clinical capacity for the differential diagnosis of this rare condition.