Differential Diagnosis for a Mass Under the Tongue
- Single Most Likely Diagnosis
- Ranula: A mucous cyst or mucocele that forms under the tongue, often due to the obstruction of the sublingual gland or duct. This is a common and benign condition that presents as a soft, blue, translucent mass.
- Other Likely Diagnoses
- Sublingual gland tumor (benign or malignant): Tumors of the sublingual gland can present as masses under the tongue. While less common than ranulas, they are still within the realm of likely diagnoses due to their anatomical location.
- Dermoid cyst: A type of teratoma that can occur under the tongue, presenting as a firm, sometimes fluctuant mass. These are congenital and can grow over time.
- Thyroglossal duct cyst: Although more commonly found in the midline of the neck, a thyroglossal duct cyst can occasionally present under the tongue if it tracks upwards.
- Do Not Miss Diagnoses
- Squamous cell carcinoma: A malignant tumor that can present as a mass under the tongue. Given its potential for aggressive behavior and metastasis, it is crucial not to miss this diagnosis.
- Lymphoma: Both Hodgkin's and non-Hodgkin's lymphoma can present with masses in the oral cavity, including under the tongue. Early diagnosis is critical for effective treatment.
- Metastatic disease: Although rare, metastases from other primary cancers can present as masses under the tongue, emphasizing the importance of a thorough medical history and examination.
- Rare Diagnoses
- Teratoma (other than dermoid cyst): Other types of teratomas can occur under the tongue but are less common than dermoid cysts.
- Chondroma or other soft tissue tumors: Benign tumors of cartilage or other soft tissues are rare under the tongue but should be considered in the differential diagnosis.
- Granular cell tumor: A rare, usually benign tumor that can occur in the oral cavity, including under the tongue.
- Neurogenic tumors (e.g., neurofibroma, schwannoma): These are rare under the tongue but can occur, especially in patients with neurofibromatosis type 1.