Branchial cleft cyst
A branchial cleft cyst or simply branchial cyst is a cyst as a swelling in the upper part of neck anterior to sternocleidomastoid. It can, but does not necessarily, have an opening to the skin surface, called a fistula. The cause is usually a developmental abnormality arising in the early prenatal period, typically failure of obliteration of the second, third, and fourth branchial cleft, i.e. failure of fusion of the second branchial arches and epicardial ridge in lower part of the neck. Branchial cleft cysts account for almost 20% of neck masses in children. Less commonly, the cysts can develop from the first, third, or fourth clefts, and their location and the location of associated fistulas differs accordingly.
| Branchial cyst | |
|---|---|
| Other names | Branchial arch fistula Benign cervical lymphoepithelial cyst Pharyngeal arch cyst |
| Fistulogram (sinogram) of a right branchial cleft sinus. | |
| Specialty | Medical genetics |
| Symptoms | Painless, firm mass lateral to midline, usually anterior to the SCM, which does not move with swallowing |
| Causes | Family history |
| Differential diagnosis | Vascular anomaly, dermoid cyst, thymic cyst, lymphadenopathy, lymphoma, HPV-related oropharyngeal cancer |
| Treatment | Conservative, surgical excision |
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