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Ranulas are mucoceles that develop as a result of mucous extravasation from the sublingual gland and typically present in the floor of mouth. The treatment of ranulas are various, mainly including surgical and nonsurgical methods. The preferred treatment of oral and plunging ranulas is still uncertain. According to the complications associated with surgical therapy, nonsurgical sclerotherapy has been advocated by clinicians for its advantages of less injury, no scar, less suffering, etc. Recently, it was reported that OK-432 was a relatively effective sclerosing agent for both lymphatic malformations and ranulas, although it has a high rate of recurrence after treating ranulas. Pingyangmycin is another reported conventional sclerosing agent for lymphatic malformations. Herein, we hypothesize that intracystic injection of pingyangmycin may be an optimal method for the treatment of ranulas.

Hemangiomas and vascular malformations are the most common vascular lesions in infants and children. In the past years, due to the lack of definite classification and distinctions of vascular lesions, misdiagnosis and mismanagement were often encountered and the patients underwent inappropriate treatment. A renaissance began with the biological classification proposed by Mulliken and Glowacki in 1982. They categorized vascular lesions into hemangiomas and vascular malformations, which were absolutely different both clinically and biologically. Hemangiomas are benign tumors of infancy that have a proliferation phase followed by subsequent involution throughout childhood. Vascular malformations result from errors of vascular morphogenesis, they grow commensurate with the patient throughout life and never involute. From a prognostic standpoint, vascular malformations may need intervention as early as possible. So we must differentiate hemangiomas from vascular malformations early and accurately. In this review, we summarize the highlights of the diagnosis between hemangiomas and vascular malformations. Supported by Shanghai Leading Academic Discipline Project (Grant No.Y0203).