Diagnosis and treatment of branchial cleft
cysts and fistulae.
1) The differential diagnoses for the contents are as follows: metastatic disease, lymphoma, adenitis, obstructed submandibular duct, salivary gland tumors, abscess, Ludwig's angina, thyroglossal duct cyst, hemangioma, lymphangioma, dermoid/epidermoid, diving ranula (complex), second branchial cleft
cyst (more common in children) (Figure 16).
John was diagnosed with a unilateral branchial cleft
cyst and was referred to an otolaryngologist.
Based on the anatomic location of the mass, clinical presentation, histopathologic characteristics, and CK-positive immunolabeling, the diagnosis was branchial cleft
cyst, similar to second branchial cyst type II-III reported in humans.
Prior to referral, an ultrasound scan was carried out and revealed a 5 x 2 cm multiloculated (septated) cystic swelling, with internal septae, related to the right sternocleidomastoid with an initial impression of branchial cleft
cyst with internal haemorrhage.
This combination of findings often results in misdiagnosis as branchial cleft
cysts or as carcinoma arising in a branchial cleft
A common type of branchial cleft
anomaly is a preauricular anomaly that "begins as a pit in the preauricular region and often extends via a sinus tract down to a cystic dilatation almost always at the root of the helix," Dr.
A number of other types of neck masses may be found in children, including cystic hygroma, hemangioma, lymphangioma, branchial cleft
cyst, blocked salivary duct, acute infection, and others.
One case had branchial cleft
cyst and CT showed a cystic lesion with good delineation of the extent of the lesion.
anomalies occur as a result of incomplete obliteration of the branchial clefts
38) The most commonly accepted theory of anomalous development is persistence of trapped cell rests from incompletely obliterated branchial apparatus, resulting in development of branchial cleft
cysts later in life.
The differential diagnosis of cystic cervical masses includes thyroid cyst, thymic cyst, thyroglossal duct cyst, branchial cleft
cyst, bronchogenic cyst, lymphangioma and parathyroid cyst (PC) (1).
The 2 lesions that first come to mind in the differential diagnosis of a solitary cystic lesion in the neck are thyroglossal duct cyst and branchial cleft
Among the branchial anomalies, second branchial cleft
anomalies are most common, representing approximately 95% of cases.
anomalies make up 30% of all pediatric neck masses, but complete second branchial cleft
anomalies are extremely rare.