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N Engl J Med 2022 06 18;386(25):e67. Epub 2022 Jun 18.

Tokyo Metropolitan Children's Medical Center, Tokyo, Japan

Int J Surg Case Rep 2022 Jun 11;95:107192. Epub 2022 May 11.

Department of Surgery, Otolaryngology-Head and Neck Surgery Unit, King Faisal University, Alahsa, Saudi Arabia. Electronic address:

Introduction: Thyroglossal cysts represent 70% of congenital neck anomalies, and second branchial cleft anomalies are the most common anomalies (90%) of the branchial apparatus. However, their coexistence, especially in adults, is very rare.

Presentation Of Case: A 23-year-old woman presented with a 1-year history of lateral left neck swelling and midline swelling. Read More

J Ultrason 2022 Mar 8;22(88):e67-e69. Epub 2022 Feb 8.

Emergency Medicine, Lakeland Regional Health, United States.

Aim Of The Study: Branchial anomalies result from incomplete obliteration of the branchial arch structures during embryogenesis. Second branchial arch anomalies are commonly found on the lower third of the neck, with an opening at the anterior border of the sternocleidomastoid muscle, and may drain secretions or purulent material. This case demonstrates the use of handheld point-of-care ultrasound to aid in the diagnosis of a branchial anomaly. Read More

Autops Case Rep 2022 21;12:e2021361. Epub 2022 Feb 21.

All India Institute of Medical Sciences, Department of Pathology and Lab Medicine, Jodhpur, Rajasthan, India.

Cervical thymic cysts are relatively rare benign cystic lesions that tend to be diagnosed clinically as branchial cysts, which usually present as painless, enlarging neck masses. They can occur anywhere along the normal path of descent of thymic primordia from the angle of the mandible to the sternal notch, with mediastinal extension observed in approximately 50% of cases. They are usually seen in the first decade of life on the left side with a male predominance. Read More

Ann R Coll Surg Engl 2022 Feb;104(2):44-46

Pennine Acute Hospitals NHS Trust, UK.

The branchial system plays a significant role in the embryological development of the many internal and external human body structures. Failure of normal development of these systems may result in branchial system anomalies. Anomalies of the first branchial cleft are rare and account for 1-8% of all branchial anomalies. Read More

BMJ Case Rep 2021 Oct 8;14(10). Epub 2021 Oct 8.

Department of Pathology - Head and Neck Cytopathology, University of Miami Miller School of Medicine, Miami, FL, USA.

Cervical thymic cysts (CTCs) represent 1% of all cervical cystic masses. A review of the literature found that CTCs are typically asymptomatic, with a propensity to be left sided. CTCs often require histological evaluation for diagnosis. Read More

AJNR Am J Neuroradiol 2021 11 7;42(11):2094-2100. Epub 2021 Oct 7.

From the Department of Radiology and Biomedical Imaging (Y.L., C.E.L., V.A.F., O.A.G.), Neuroradiology Section, University of California San Francisco, San Francisco, California.

Background And Purpose: Third and fourth branchial apparatus anomalies are rare congenital anomalies. The purpose of this study was to investigate imaging features of these lesions on fetal MR imaging in comparison with lymphatic malformations, the major competing differential diagnosis in these cases.

Materials And Methods: A retrospective review of our institutional fetal MR imaging database between 1997 and 2019 resulted in 4 patients with confirmed third and fourth branchial apparatus anomalies and 14 patients with confirmed lymphatic malformations. Read More

Dermatopathology (Basel) 2021 Aug 1;8(3):342-358. Epub 2021 Aug 1.

Department of Pathology, University Hospital of Nantes, 44000 Nantes, France.

Background: neck cysts are frequently encountered in pediatric medicine and can present a diagnostic dilemma for clinicians and pathologists. Several clinical items enable to subclassify neck cyst as age at presentation, anatomical location, including compartments and fascia of the neck, and radiological presentation.

Summary: this review will briefly describe the clinical, imaging, pathological and management features of (I) congenital and developmental pathologies, including thyroglossal duct cyst, branchial cleft cysts, dermoid cyst, thymic cyst, and ectopic thymus; (II) vascular malformations, including lymphangioma. Read More

Ann R Coll Surg Engl 2022 Feb 27;104(2):e44-e46. Epub 2021 Aug 27.

Pennine Acute Hospitals NHS Trust, UK.

The branchial system plays a significant role in the embryological development of the many internal and external human body structures. Failure of normal development of these systems may result in branchial system anomalies. Anomalies of the first branchial cleft are rare and account for 1-8% of all branchial anomalies. Read More

BMJ Case Rep 2021 Aug 26;14(8). Epub 2021 Aug 26.

Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka - 576104, India.

First branchial cleft anomalies are quite rare, and the majority of them are found in and around the ear canal, mostly superficial to the facial nerve. Very rarely, the anomalous tract of the first branchial cleft can go deeper to the facial nerve, necessitating a meticulous and extensive surgery. A 21-year-old student presented with slowly increasing cystic swelling in the infra-auricular region. Read More

J Pediatr Health Care 2021 Sep-Oct;35(5):548-551. Epub 2021 Jul 23.

Neck masses are a common finding in the pediatric population, with a broad differential diagnosis resulting in real diagnostic challenges. They are most frequently caused by reactive lymphadenopathy, infectious lymphadenitis, or congenital anomalies of the neck. This case report describes a 16-year-old female presenting to the pediatric emergency department with 5 weeks of right-sided neck mass. Read More

BMC Surg 2021 Jul 3;21(1):306. Epub 2021 Jul 3.

Department of Otolaryngology, Xijing Hospital, Fourth Military Medical University, Xi'an, 710032, Shaanxi Province, China.

Background: First branchial cleft anomaly (FBCA) is a rare congenital defect that arises due to incomplete closure of the ventral portion of the first and second branchial arches. There are variable complex clinical manifestations for patients with FBCA, which are prone to misdiagnosis and inadequate treatment. FBCAs usually involve the facial nerve with a consequent increased risk of facial nerve damage. Read More

J Small Anim Pract 2021 Dec 7;62(12):1131. Epub 2021 Jun 7.

Clinica Veterinaria Borghesiana, Via di Vermicino 96, 00133 Rome, Italy.

J Clin Ultrasound 2021 Nov 4;49(9):966-968. Epub 2021 Jun 4.

Department of Obstetrics, Paulista School of Medicine, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.

Branchial cleft cysts (BCCs) are common causes of cervical tumors in children and adulthood; however, prenatal diagnosis of BCC is rare. In neonates, these cysts can suddenly increase in size, causing airway obstruction and becoming a life-threatening condition. In this case report, we describe the prenatal diagnosis of a third BCC at the 25th week of pregnancy using ultrasound, magnetic resonance imaging, and three-dimensional virtual models, as well as the perinatal outcomes of this rare condition. Read More

J Int Med Res 2021 May;49(5):3000605211012549

Department of Otolaryngology, The Third People's Hospital of Chengdu, Chengdu, Sichuan, China.

Third branchial cleft cyst is a rare congenital disease of the neck. It presents as a painless mass that develops rapidly in the neck following an infection. This is the first case report of recurrent laryngeal nerve palsy caused by a third branchial cleft cyst. Read More

Orv Hetil 2021 04 2;162(15):595-600. Epub 2021 Apr 2.

5 Borsod-Abaúj-Zemplén Megyei Központi Kórház és Egyetemi Oktatókórház, Fül-Orr-Gége és Fej-Nyak Sebészeti Osztály, Miskolc.

Összefoglaló. A lateralis cysticus nyaki terimék két leggyakoribb oka a branchiogen cysta és a cysticus nyaki áttét. Az átfedő lokalizáció (a leggyakrabban a IIA nyaki régióban), a betegek életkora és az esetenként hirtelen kezdet alapján a két leggyakoribb ok differenciáldiagnózisa nagy kihívást jelenthet. Read More

Pan Afr Med J 2020 10;37:334. Epub 2020 Dec 10.

Service d´Oto-Rhino-Laryngologie et de Chirurgie Cervico-Faciale, Faculté de Médecine et Pharmacie de Rabat, Université Mohamed V de Rabat, Hôpital Militaire d´Instruction Mohamed V de Rabat, Rabat, Maroc.

Parotid branchial cysts are rare and poorly known congenital malformations of the first branchial cleft. They are characterized by three types of manifestations which may be associated to it or isolated, including inflammatory swelling of the subauricular and inferior portion of the parotid with or without cervico-cutaneous fistula projecting into the cervico-mandibular area and a fistula in the floor of the external auditory canal with or without otorrhea, with or without pretimpanic bridle on otoscopy. They often go unnoticed, except for superinfections. Read More

Medicine (Baltimore) 2021 Jan;100(3):e24375

Department of Otolaryngology-Head and Neck Surgery.

Rationale: The diagnosis of type IV branchial cleft cyst (BCC) according to the Bailey classification is very challenging due to lack of specific clinical manifestations in the early stage of the disease. Here, we present the transoral surgical route of endoscopic resection of second BCC in the parapharyngeal space (PPS) with good outcomes.

Patient Concerns: A 21-year-old man with a 1-year history of snoring complained about sore throat for 1 month and a fever that lasted for 3 days. Read More

Head Neck 2021 04 3;43(4):E27-E29. Epub 2021 Feb 3.

Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai Hospital, Mount Sinai Beth Israel, New York, New York, USA.

Background: Second branchial cleft cysts (SBCCs) are congenital benign tumors that comprise up to 90% of all branchial cleft anomalies. SBCCs typically present in the lateral neck along the anterior border of the upper third of the sternocleidomastoid muscle. We describe a case of a SBCC presenting in an unusual location in the lower neck close to midline. Read More

BMJ Case Rep 2021 Jan 12;14(1). Epub 2021 Jan 12.

Otorhinolaryngology and Head and Neck Surgery, Klinikum Mutterhaus der Borromäerinnen gGmbH, Trier, Deutschland, Germany

The anatomy of the parapharyngeal space (PPS) is complex and the differential diagnosis of tumours in this area broad. Although primary tumours of the PPS account for only 0.5% of head and neck neoplasms and are benign lesions in 80% of the cases, the surgical management is crucial and needs specific planning and evaluation of CT and/or MRI scans. Read More

Case Rep Otolaryngol 2020 8;2020:8814071. Epub 2020 Dec 8.

Department of Otorhinolaryngology-Head & Neck Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Second branchial cleft cysts (BCCs) are common congenital causes of neck swellings; however, isolated parapharyngeal space presentation is extremely rare, with only sporadic cases reported. Our objectives in this report are to describe a case and review different diagnostic and management strategies adopted in the current world literature. The case presented is a 26-year-old female with a large isolated parapharyngeal BCC extending to skull base in which first presenting symptoms were referred otalgia and painful side-to-side head rotation for months followed by odynophagia. Read More

Cancer Rep (Hoboken) 2021 04 9;4(2):e1315. Epub 2020 Dec 9.

Department of Multidisciplinary Medical, Surgical and Dental Specialties, University of Campania "Luigi Vanvitelli", Naples, Italy.

Background: Primary branchiogenic carcinoma (PBC) is an extremely rare and poorly documented disease developed from a brachial cleft cyst.

Case: A 51-year-old patient was referred to our unit for an upper neck mass. PBC was confirmed in accordance with Kahfif's diagnostic criteria. Read More

Ear Nose Throat J 2022 May 13;101(4):NP146-NP148. Epub 2020 Sep 13.

Columbia Surgical Associates, 49477Spokane ENT, Spokane, WA, USA.

Branchial cleft anomalies are embryonic remnants of the branchial arches and are described as the second most common congenital neck mass. Depending on their extent, these anomalies are classified as a cyst, sinus, or fistula with branchial cysts being the most common. Branchial cysts deriving from the second branchial arch are by far the most common, accounting for approximately 95% of all cases. Read More

BMJ Case Rep 2020 Sep 6;13(9). Epub 2020 Sep 6.

Ear, Nose and Throat Surgery Department, Great Ormond Street Hospital For Children NHS Trust, London, UK.

A 1-week-old female infant presented with a transilluminating neck lump that increased in size with crying. The presumptive diagnosis was lymphatic malformation, but imaging raised the possibility of an abscess or necrotic tumour. A biopsy revealed a likely developmental cyst with local inflammatory change. Read More

Int Arch Otorhinolaryngol 2020 Jul 9;24(3):e347-e350. Epub 2020 Jan 9.

Department of Otorhinolaryngology, Hospital de Ninos Baca Ortiz, Quito, Pichincha, Ecuador.

 Branchial cleft anomalies are the second most common congenital anomaly in children. However, some lesions may not develop clinically and are not diagnosed until adulthood. The recent literature of branchial cysts (BCs) in the adult population is really scanty. Read More

Am J Otolaryngol 2020 Nov - Dec;41(6):102623. Epub 2020 Jun 24.

Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University Hospital of Dijon, Dijon, France. Electronic address:

Emerg Radiol 2021 Feb 19;28(1):177-183. Epub 2020 Jun 19.

Department of Imaging Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, P.O. Box 648, Rochester, NY, 14642, USA.

There are a wide variety of inflammatory, infectious, and cystic lesions which may lead patients to seek acute care for facial swelling. Computed tomography (CT) has become the mainstay for imaging in the urgent/emergent setting. However, magnetic resonance imaging (MRI) can also serve as a powerful problem solving tool in the modern era. Read More

J Otolaryngol Head Neck Surg 2020 May 29;49(1):32. Epub 2020 May 29.

Department of Pediatric Otolaryngology - Head and Neck Surgery, Hôpital Necker - Enfants Malades - Paris V University, Paris, France.

Background: First branchial cleft anomalies are rare, accounting for only 10% of all branchial cleft anomalies. We report an even more rare and unique case of a branchial cleft cyst with features of both first and second arch derivatives.

Case Presentation: A 6-year-old boy presented to us with a left conductive hearing loss associated with pre-tympanic keratin debris and an ipsilateral painful cervical mass. Read More

Radiol Clin North Am 2020 May;58(3):639-652

Division of Thoracic Imaging, Department of Radiology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA 20115, USA. Electronic address:

Congenital entities sharing imaging characteristics with true pathologies occasionally are discovered incidentally in adults. These may occur in the neck, chest, abdomen/pelvis, or musculoskeletal systems. Although these incidental findings share imaging features with true pathologic processes, up-to-date knowledge and assessment with the most appropriate imaging modalities generally allow a distinction between congenital entities that may be safely dismissed and pathologic processes requiring further assessment and treatment. Read More

Clin Imaging 2020 Aug 15;64:1-6. Epub 2020 Feb 15.

Department of Radiology, Baylor College of Medicine, Houston, TX, USA.

Branchial cleft cysts are the most common lesions in the lateral neck with ectopic thyroid tissue found only rarely within these cysts. Over the years, multiple cases of papillary thyroid carcinoma arising from these ectopic thyroid tissues have been described in the literature with these cases sharing a normal thyroid gland on surgical and histological evaluation. Recently, however, there are three cases of papillary thyroid carcinoma in a branchial cleft cyst reported to be the result of metastasis from a thyroid primary. Read More