e describe a case of a rare cystic, exophytic salivary gland tumor diagnosed in a fetus at an estimated gestational age of 25 weeks. The combined use of 2-dimensional (2D) and 3-dimensional (3D) sonography allowed determination of the tumor's origin. Sonographically guided aspiration of the tumor's content produced fluid with the consistency of mucus. Detection of amylase in the fluid confirmed that the lesion was of salivary origin and established the diagnosis of a ranula. Prenatal decompression of the ranula allowed spontaneous vaginal delivery of a full-term girl with excellent Apgar scores at 1 and 5 minutes.
Case ReportA 13-year-old pregnant patient was referred to our prenatal diagnostic unit for a sonographic examination. The estimated gestational age based on her last menstrual period was 25 weeks. The patient was found to have a singleton gestation with a female fetus. Biometric measurements with 2D sonography showed the fetal age to be consistent with the patient's last menstrual period and revealed a cystic tumor measuring 5.0 × 4.0 cm protruding through the mouth. The tumor seemed to originate in the sublingual area of the mouth. Color Doppler scanning revealed no vascular flow in the tumor. We were able to observe the wide-open mouth of the fetus and to confirm the sublingual origin of the cyst more precisely with 3D sonography (Figure 1). A sonographic anatomic survey revealed that there was fluid in the stomach of the fetus. All other fetal organs and the amniotic fluid index (14) were normal. Cytogenetic anal-
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