Diagnosis

Branchial cleft cyst

Etiology

Cause

• Congenital lesions arising from remnants of the branchial arches or pharyngeal pouches during embryonic development

Pathophysiology [tcs]

• There are 5 branchial arches separated by 4 depressions known as clefts

• Branchia (Greek word for gills, evolutionary link to the gill slits of amphibians)

• Embryonic origin:

  • Grooves: derived from ectoderm

  • Arches: derived from mesoderm

  • Pouches: derived from endoderm

• May not present until adulthood and may become evident only with infection and inflammation --> swelling --> cysts, sinuses, or fistulas

Complications [tcs]

• Abscess

• Development of a malignancy (squamous cell carcinoma)

• Airway compromise

Epidemiology

Incidence per 100.000 [yke][7ut][wff]

Approach

• Ultrasound collum

Treatment

1. Infection --> Antibiotics and drainage of abscess

2. Definitive treatment --> elective surgical excision [tcs]

3. If surgery is not an option: ethanol ablation therapy

Differential diagnoses

Carotid aneurism, Cat scratch disease, Cystic hygroma, Dermoid Cyst, Hemangioma, Lymphadenopathy, Peritonsillar abscess, Squamous cell carcinoma, Thyroglossal duct cyst, Thyroid abscess, Thyroid cancer, Toxic nodular goiter