A case of third branchial cleft cyst

Authors

  • G. Raghavendra Prasad Department of Paediatric Surgery, Princess Esra Hospital, Deccan College of Medical sciences, Hyderabad, Telangana, India
  • J. V. Subba Rao Department of Anaesthesia, Princess Esra Hospital, Deccan College of Medical sciences, Hyderabad, Telangana, India
  • Bushra Khan Department of General Surgery, Princess Esra Hospital, Deccan College of Medical sciences, Hyderabad, Telangana, India
  • Amtul Aziz Department of General Surgery, Princess Esra Hospital, Deccan College of Medical sciences, Hyderabad, Telangana, India

DOI:

https://doi.org/10.18203/2349-2902.isj20181622

Keywords:

Branchial anomalies, Branchial arches, Third branchial cleft cyst

Abstract

Branchial cyst or congenital cystic lesions of neck originate from branchial clefts, the 2nd branchial cleft cyst being the most common and 3rd and 4th being missed. Hence, they are often misdiagnosed as lymph nodal masses, cold abscess. We are reporting a case of 3rd Branchial cleft cyst, of a 12-year-old boy who presented with left sided recurrent painful cystic mass at the level of hyoid bone going down to the level of pyriform fossa. All the tests for tuberculosis were negative. USG neck revealed loculated thick walled cyst from SCM to lateral part of pharynx. CECT revealed a thick-walled cyst extending from the anterior border of the sternocleidomastoid going down obliquely below the level of thyrohyoid membrane to pyriform fossa. Exploration revealed a thick walled infected cyst, pushing left upper pole of thyroid medially and anterior to left sided superior laryngeal nerve. The cyst was going downwards medially below the level of thyrohyoid membrane. The cyst was excised completely. Histopathology revealed the findings of squamous epithelial lining of cyst wall and cholesterol crystals within. Detailed anatomy on CECT, surgery and histopathology confirmed 3rd arch Branchial cyst.

References

Salder TW. Langhan’s medical embryology, 12th Edition. Lippincott Wiliams and Wilkins; 2012:260-73.

Frisdal A, Trainor PA. Development and evolution of the pharyngeal apparatus. Wiley Interdiscip Rev Dev Biol. 2014;3(6):403-18.

Kenealy JF, Torsiglieri AJ, Tom LW. Branchial cleft anomalies: a five-year retrospective review. Trans Pa Acad Ophthalmol Otolaryngol. 1990;42:1022-5.

Reiter D. Third branchial cleft sinus. an unusual cause of neck abscesses. Int J Pediatr Otorhinolaryngol. 1982;4:181-6.

Chandler JR, Mitchell. Branchial cleft cysts, sinuses and fistulas. Otolaryngol Clin North Am. 1981;14:175-86.

Koch BL. Cystic malformations of the neck in children. Pediatr Radiol. 2005;35:463-77.

Waldhausen J. Branchial cleft and arch anomalies in children. Semin Pediatr Surg. 2006;15:64-9.

Maran AGD, Buchanan DR. Branchial cysts: Sinuses and Fistulae. Clin Otolaryngol. 1978;3:77-92.

Srinjeeta G, Yuvraj P, Karan V, Adip S, Haritosh V. Third branchial cleft cyst presentation in adulthood: a case report. Otolaryngol Online J. 2014;4(4):191.

Joshi MJ, Provenzano MJ, Smith RJH, Sato Y, Smoker WRK. The rare third branchial cleft cyst. Am J Neuroradiol. 2009;3 (9):1804-6.

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Published

2018-04-21

Issue

Section

Case Reports