Branchial cleft cysts: serie of 33 cases and review of the literature

Abstract

Branchial cleft cysts develop because an anomaly in the caudal growth of the second arch over the third and the fourth ones. They usually present as an asymptomatic circumscribed movable mass, close to the anterior border of the sternocleidomastoid muscle. The location depends on the branchial pouch or cleft they are derived from. We present a retrospective study including 30 cases analysing epidemiology, clinical presentation, diagnosis, treatment and complications. We obtained the following results: 15 of the 30 patients were females and 15 males. Age ranged from 19 to 81 years with an average of 40. All cysts had origin from the second branchial cleft. Twenty-three appeared as painless cervical masses, 5 were painful and 2 had an infection. Clinical suspicion of branchial cleft cyst formed in 23 cases. Computerized tomography and fine needle aspiration cytology was used in 18 cases, magnetic resonance alone in 1 and only ultrasound in 1. Branchial cleft cyst is a differential diagnosis of a lateral neck swelling mass and the most accurate diagnostic test is magnetic resonance, but computerized tomography is the most often performed in most hospitals. Treatment is surgical excision.