Plunging ranula (32)

Big plunging ranula which was diagned as lipoma or lymphangioma

Young man. He first noticed right  submandibuler swelling 2 years ago, Then he went to a hospital. ENT doctor told him that he had llipoma and needed extirpation operation. He did not want to have surgery, so he hesitated to be treated. Several months after, his right submandibuler swelling was spontaneously decreased. But, 3 months ago, his right submandibuler swelling became increased again. He went to another  doctor and had MRI study. Plastic surgeon told him thst he had lymphangioma and needed very difficult extirpation operation.
He found my website and came to me from very far place.

These are his MRI images. White lesion means fluid collection. I think this is typical ranula MRI. And his ranula exists in front of submandubuler gland. This means OK-432 therapy is easy.


I punctured his right submandibuler swelling with big (18 gauge) needle. After aspiration of 12 ml cyst fluid. 1.5 KE of OK-432 suspended with 2 ml saline was injected. Upper left is cyst fluid and upper right are  its smear. Cyst fluid was yellowish biscous fluid. This is typical ranula fluid.

This is the course of his treatment. 12 ml of cyst fluid was removed and then 2 ml of OK-432 susupensioin was injected. So, his submandibular swelling was a little reduced at just after treatment. But at the next day, his ranula was swollen. This means good response. 1 week after treatment, swelling was maximum. After 2 weeks, his ranula began to shrink. 6 weeks after treatment, there was no swelling.

Operation is difficult when the ranula is big. But, OK-432 treatment is easy and safe when the ranula is big.
21 yeras ago OK-432 therapy for lymphangima and  yerars ago, OK-432 therapy for ranula was approved by national medical insurance in Japan.
Regrettably, even in Japan, the doctors who believe this therapy are limitted.

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