Branchial Cyst Research Articles

Early presentation of complete branchial fistula with review of literature

Branchial anomalies are rarely seen in clinical practice. They arise as a result of aberrations of the branchial apparatus during fetal development. Though present since birth, they are usually diagnosed in the first or second decade of life. Second arch anomalies are by far the most common and present as a neck mass or discharging sinus that may be complicated by infection. Clinical examination often reveals the lesion to be related to the junction of the upper two thirds and the lower one third of the sternocleidomastoid muscle. Branchial fistulas often present as a discharging sinus in the neck. The fistulous tract may extend for a variable distance within the neck. However complete branchial fistula of the second cleft with an internal opening in the tonsillar area and an external opening in the skin is rare. Surgical excision using the step ladder approach was used. No recurrence was seen at one year follow up. The incidence of such lesions presenting within first two years of age is extremely rare. Surgical excision is the treatment of choice for branchial anomalies. We present the case of a two-year-old female patient with complete branchial fistula and discuss the clinical presentation and surgical management of such lesions, while reviewing the relevant literature.

Complete Second Branchial Fistula: A Rare Entity.

Second branchial anomalies like branchial cyst, sinus or fistula are common lateral neck masses in pediatric age group but it is rare to encounter complete branchial fistula with external as well as internal openings. We present a case of 16 yrs old female patient with complete Branchial fistula which was diagnosed with the help of CT fistulogram and thereafter taken up for surgical excision of fistula under general anaesthesia. Histopathology confirmed the diagnosis of branchial fistula. In case of lateral neck mass with external opening in pediatric age group strong possibility of diagnosis of branchial fistula should be kept, timely management of the case improves the quality of life.

Synchronous Presentation of Right Parotid Branchial Cleft Cyst and Left Neck HPV-Associated Cystic Metastatic Squamous Cell Carcinoma: A Diagnostic Quandary.

Branchial cleft cyst arising within the parotid space is considered an extremely rare phenomenon. In contrast, cystic squamous cell carcinoma in the lateral neck is not an uncommon presentation of HPV-related head and neck cancer. Although they have singly been narrated in literature, simultaneous expression of these anomalies has yet to be reported. We describe a case of synchronous presentation of branchial cleft cyst of the right parotid gland and cystic metastatic squamous cell carcinoma of the left neck. These findings are discussed in light of the challenges in fine needle aspiration biopsy of cystic masses, and the risk of two distinct pathologic entities presenting as cysts in the head and neck.

Characteristics of systematic lymph node dissection and influencing factors of sentinel lymph node biopsy using carbon nanoparticles in endometrial carcinoma: a single-center study

BackgroundCarbon nanoparticles (CNPs) are a new tracer for lymph node mapping, which can quickly reach and develop lymph nodes through a lymphatic network. This research investigated the characteristics of systematic lymph node dissection and sentinel lymph node biopsy mapped with CNPs in endometrial carcinoma.MethodsWe first applied CNPs to systematic lymph node dissection in 18 endometrial carcinoma patients as the study group and another 18 endometrial carcinoma patients who were not injected with anything served as the control group. Then, we applied CNPs to sentinel lymph nodes biopsy in 54 endometrial carcinoma patients. All 54 patients received systematic lymph node dissection after sentinel lymph node biopsy. The detection rate, sensitivity, specificity, and accuracy of systematic lymph node dissection and sentinel lymph node biopsy by CNPs were respectively analyzed. A nomogram model for predicting the success of sentinel lymph node mapping was established.ResultsThe average number of lymph nodes removed in the CNP-labeled study group was higher than that in the control group (p<0.001). CNPs improved the number of lymph nodes with a diameter ≤ 0.5cm. The detection rate, sensitivity, specificity, and accuracy of sentinel lymph nodes biopsy by CNPs for endometrial carcinoma were 70.4%, 100%, 100%, and 100%, respectively. The nomogram model included factors of long menopause time, cervical cyst, and hard cervical texture, and the area of ROC curve was 0.816.ConclusionsCNPs improve the detection rate of small lymph nodes. CNPs can trace sentinel lymph nodes in evaluating lymph node metastasis in endometrial carcinoma.

Fourth branchial cleft cyst in an infant. Case report and modified surgical approach

Fourth branchial cleft anomalies are rare anomalies with a wide variety of clinical symptomatology and different surgical approaches. These approaches has been described with variable success and rates of complications with no standard surgical approach described. In this case report we present an infant with left sided fourth branchial cleft cyst treated with a modified surgical approach combining endoscopic identification of the inner opening and insertion of a fine guidewire followed by surgical excision and ligation of the fistula tract.

Tracheal Deviation and Life-threatening Presentation of Congenital Branchial Cleft Cyst Abscess due to Rare Pathogens and Difficult Airway Management.

Tracheal Deviation and Life-threatening Presentation of Congenital Branchial Cleft Cyst Abscess due to Rare Pathogens and Difficult Airway Management.

Atavistic and vestigial anatomical structures in the head, neck, and spine: an overview.

Organisms may retain nonfunctional anatomical features as a consequence of evolutionary natural selection. Resultant atavistic and vestigial anatomical structures have long been a source of perplexity. Atavism is when an ancestral trait reappears after loss through an evolutionary change in previous generations, whereas vestigial structures are remnants that are largely or entirely functionless relative to their original roles. While physicians are cognizant of their existence, atavistic and vestigial structures are rarely emphasized in anatomical curricula and can, therefore, be puzzling when discovered incidentally.In addition, the literature is replete with examples of the terms atavistic and vestigial being used interchangeably without careful distinction between them. We provide an overview of important atavistic and vestigial structures in the head, neck, and spine that can serve as a reference for anatomists and clinical neuroscientists. We review the literature on atavistic and vestigial anatomical structures of the head, neck, and spine that may be encountered in clinical practice. We define atavistic and vestigial structures and employ these definitions consistently when classifying anatomical structures. Pertinent anatomical structures are numerous and include human tails, plica semilunaris, the vomeronasal organ, levator claviculae, and external ear muscles, to name a few. Atavistic and vestigial structures are found throughout the head, neck, and spine. Some, such as human tails and branchial cysts may be clinically symptomatic. Literature reports indicate that their prevalence varies across populations. Knowledge of atavistic and vestigial anatomical structures can inform diagnoses, prevent misrecognition of variation for pathology, and guide clinical interventions.

Web in the Neck – An Interesting Case Report

Lateral neck masses are common in children, ranging from simple benign diseases to pathologies with malignant potential. Plexiform neurofibromas are extremely rare peripheral nerve sheath tumours involving multiple nerve sheath fascicles. They are typically seen in the paediatric population, with the majority affecting the craniofacial area and neck. Due to the close clinical and histological resemblance with other benign neck lesions such as lymphadenitis and branchial cysts, these cases can often go misdiagnosed. We describe a lesion in a young girl who presented with a progressive lateral neck swelling and how it was managed.

Primary Papillary Thyroid Carcinoma Arising in a Branchial Cleft Cyst – Navigating a Hidden Malignancy on Histopathology

Primary Papillary Thyroid Carcinoma Arising in a Branchial Cleft Cyst – Navigating a Hidden Malignancy on Histopathology

Papillary thyroid carcinoma metastasis to a branchial cleft cyst

Branchial cleft cysts (BCCs) are the most common benign masses of the lateral neck. However, rarely, it can develop into a malignant cyst, either as a primary or a metastatic lesion. We report an extremely rare case of papillary thyroid carcinoma (PTC) metastasis to the BCC. The patient clinically presented with a palpable neck mass, and computed tomography revealed a well-defined, thin-walled cystic mass with a small contrast-enhanced mural nodule. Surgical excision of the cystic mass was performed, and the histopathologic results revealed a BCC with a microscopic papillary carcinoma. Thyroid evaluation and thyroidectomy were subsequently performed, and a PTC was confirmed. The imaging findings and differential diagnosis are discussed in this report.

Papillary thyroid carcinoma arising from ectopic thyroid tissue in a neck branchial cyst

A 35-year-old man presented with a right lateral neck mass for 6 years. Thyroid function test was within normal limits. Computed tomography scan of the neck was suggestive of branchial cyst, tuberculous lymphadenopathy and normal thyroid gland. Fine needle aspiration cytology of cervical lymph node was suggestive of metastatic carcinoma. Branchial cystectomy spearing the thyroid gland was undertaken. Histopathology analysis of the resected specimen confirmed it to be papillary thyroid carcinoma originating from ectopic thyroid tissue in a branchial cyst. The patient was scheduled for total thyroidectomy and neck dissection. Unfortunately, he was lost to follow-up. A brief review of the literature regarding this unusual presentation of thyroid cancer has been provided.

Medical and surgical approach to a second branchial cleft cyst: report of a case in the city of Puebla, México

Índice1 Introduction2 Clinical case3 Discussion Twitter Facebook Pinterest LinkedIn WhatsApp https://doi.org/10.58842/JIDL9976 Incluido en la revista Ocronos. Vol. V. Nº 7–Julio 2022. Pág. Inicial: Vol. V; nº 7: 101-2 Autor principal (primer firmante): Dr. Valeriano Torres Luis Prudencio Fecha recepción: 11 de julio, 2022 Fecha aceptación: 16 de julio, 2022 Ref.: Ocronos. 2022;5(7): 101-2 Authors: Valeriano … Medical and surgical approach to a second branchial cleft cyst: Report of a case in the City of Puebla, México Leer más »

右側頸部に生じた甲状舌管を伴わない異所性甲状腺乳頭癌例

An ectopic thyroid gland is often associated with a thyroglossal duct, as it is caused by impaired descent of the thyroid gland during development. However, in some cases, it is thyroglossal after the thyroid gland has settled in place and before the thyroid gland is formed in capsular. In some cases, an ectopic thyroid gland is said to form by invasion of the proximal tissue without a thyroglossal duct. In addition, in most cases, the ectopic thyroid tissue is seen near the midline. Herein, we report a case of papillary carcinoma arising from ectopic thyroid tissue not associated with a thyroglossal duct in the right lateral neck. The patient was a 64-year-old man who visited our department with the complaint of a mass in the right lateral neck. Ultrasonography and contrast-enhanced CT revealed a cystic lesion with a major axis diameter of about 40 mm, while no defects or neoplastic lesions were found in the intrinsic thyroid gland. Assuming a benign diagnosis, such as a lateral neck cyst or neck lymphangioma, we performed right lateral neck cystectomy. However, postoperative histopathology revealed the diagnosis of papillary carcinoma arising from ectopic thyroid tissue. There are rare reports in the literature of a lateral neck ectopic thyroid existing with the normal thyroid gland, with no thyroglossal duct, as in this case.

Successful Aspiration of a Cervical Synovial Cyst Under Fluoroscopy

Successful Aspiration of a Cervical Synovial Cyst Under Fluoroscopy

A rare cause for chronic kidney disease: Sporadic case of Branchio-Oto-Renal Syndrome : A Case report

Chronic kidney disease (CKD) is a devastating disorder which carries high morbidity and mortality if left untreated. The congenital anomalies of the kidney and urinary tract was the predominate cause for CKD in younger patients. We present an adolescent who presented with chronic kidney disease due to bilateral renal agenesis. She had features of external and internal ear abnormalities with history of branchial cyst excision during early childhood. These features were tallying with the clinical diagnosis of Branchio-Oto-Renal syndrome. This case emphasis the importance of identifying relevant congenital associations of syndrome as there may be a reversible component of them which will improve the quality of life of the patient.

甲状腺内リンパ上皮囊胞例

We report a case of lymphoepithelial cysts (LECs) of the thyroid gland that was treated by surgery at our institution. LECs are cystic lesions recognized in the head and neck region, that have been assumed to originate from embryonic remnants. Microscopically, the cysts are usually lined by squamous or squamoid epithelium, occasionally accompanied by ciliated columnar epithelium and mucous cells. The cyst wall contains abundant lymphoid tissue with germinal centers. LECs predominantly occur along the lateral neck, especially along the inside of the sternocleidomastoid muscle, when they are called lateral cervical cysts. LECs of the thyroid gland have been very rarely reported, but since they have the same histological features as lateral cervical cysts, some reports suggest that they also arise as a result of embryonic malformations. However, it still remains controversial as to whether LECs are derived from embryonic remnants or as a result of acquired inflammatory changes of pre-existing tissues. We considered that in our case, the epithelial component of the cysts developed as a result of squamous metaplastic change of thyroid follicular cells rather than from embryonic remnants.

Cytopathological Evaluation of Paediatric Non-Thyroidal Neck Swelling–Experience in a Tertiary Care Children Hospital

Background and Objective: Fine needle aspiration cytology (FNAC) is well accepted as a useful diagnostic technique in the management of adult patients with head and neck lumps. However, until recently, few reports have been obtained regarding the role of FNAC in non-thyroidal neck masses in children. Therefore, the objective of our study was to determine the diagnostic value of fine needle aspiration cytology in the diagnosis of pediatric non-thyroidal neck masses. Methods: This descriptive study was conducted at the Department of Pathology of Bangladesh Shishu (Children) Hospital &amp; Institute January 2019 to December 2021. Hundred patients with non-thyroidal neck masses fulfilling the inclusion criteria were included in the study. Fine needle aspirations were performed, smears prepared and stained by Hematoxylin and Eosin stain. Results: The most common non-neoplastic neck swelling seen in children were an enlarged lymph node due to inflammation 38(42.2%), i.e., reactive lymphadenitis. Others were TB lymphadenitis 25 (27.8%), non-TB granulomatous lymphadenitis 2(2.22%), chronic sialadenitis 2(2.22%), branchial cyst 4(4.44%) and epidermal cyst 3(3.33%) cases. Overall sensitivity, specificity, positive predictive value and negative predictive value of FNAC in our cases are 93.06%, 72.22%, 93.06% and 72.22%. Conclusion: FNA is an important diagnostic tool in the management of childhood neck lesion with the clinical presentation. The procedure decreases the requirement for more invasive and costly procedures like surgical biopsy.

Uncommon Presentation of Second Branchial Cyst Compression on the Carotid Bifurcation: A Case Report

The aim of this case report is to disclose atypical manifestations of non-epileptic seizures caused by cerebral ischemia as a result of a progressively large infected second branchial cyst compressing over the carotid bifurcation for the past three years. A female patient who presented to our clinic with symptoms of a constantly growing neck mass, pain, headache, difficulty turning the head, convulsions, teeth clenching, and syncope as a result of delayed appropriate treatment. After taking a thorough history of her signs and symptoms, along with laboratory tests and an electroencephalogram (EEG), we come to the definite diagnosis of the reason for her seizure-like symptoms, which were caused by the pressure exerted by the enlarged, infected second branchial cyst.

Neobvyklý případ dvojité fistulizace branchiogenní cysty

The authors describe a very unusual case of double external metachronous fistulation of a second branchial cleft cyst in a 54-year-old man. Signifi cant difficulties in the clinical differential dia gnosis of this developmental anomaly, comprising primarily malignant tumor and tuberculosis, were resolved only with histopathologic examination of the surgical specimen. The mechanism of the formation of both successively manifesting fistulas, developing in the milieu of chronic non-specific inflammation, is not clear. However, the absence of organoid pattern of the fistulas precludes that they were – unlike the cyst – relicts of the branchial apparatus. Key words branchiogenic cyst – fistula – differential diagnosis

Branchio-oto-renal syndrome or branchio-oto syndrome: the clinical and genetic analysis in five Chinese families

Objective: To screen the causative genes of five families with branchio-oto-renal syndrome (BORS) or branchio-oto syndrome(BOS) and to analyze the phenotypic characteristics and clinical management strategies of patients. Methods: Five families with BORS/BOR from December 2018 to September 2021 were recruited, information of patients, including family history and medical history, was collected, and genealogies were drawn. The examinations concerning audiology, nephrology, and radiology were performed on the affected individuals. Peripheral blood was obtained for DNA extraction, then next-generation sequencing technology was used to screen candidate variants associated with BORS/BOS. Based on patient's clinical results, the appropriate interventions were recommended and implemented. Results: Eight individuals were diagnosed with BOS or BORS. Of the eight patients, all had hearing loss, preauricular pits and ear malformations, and only four presented with branchial cleft fistulae or cysts. Except for two patients(5-I-2, 5-II-2) who did not undergo renal examination, the remaining six lacked renal abnormalities. Genetic analysis identified four likely pathogenic or pathogenic EYA1 variants (c.1715G>T, c.1140+1G>A, c.639G>C, c.1475+1G>C; NM_000503.6), and c.1715G>T was first reported in this study. Middle ear ossicular reconstruction was performed in 1-II-2,2-I-2 and 3-II-2, but did not yield the expected results; then hearing aids and cochlear implantation were recommended and achieved satisfactory results. Conclusions: Next-generation sequencing technology facilitates the diagnosis and genetic counseling of BORS/BOS. Hearing loss, preauricular pits, ear malformations and branchial cleft fistulae or cysts are the most common manifestations of patients in this study. Middle ear surgeries for improving hearing loss may have some limitations in BORS/BOS patients, and hearing aids and cochlear implantation can contribute to hearing gains.