Branchial Remnant Research Articles

When a Child has Neck Mass, Consider a Choristoma too! Here’s a Rare Instance: A Cervical Chondrocutaneous Branchial Remnant

When a Child has Neck Mass, Consider a Choristoma too! Here’s a Rare Instance: A Cervical Chondrocutaneous Branchial Remnant

Branchial Arch Remnants in the Pediatric Patient Under Local Anesthesia

Objective: Branchial arch remnants are a well-encountered pathology in pediatric patients. In the majority of cases, these vestiges are superficial and benign, save for minor cosmetic deformity or discomfort. Although branchial arch remnants in the form of skin vestiges are commonly removed, there remains a lack of in-depth study regarding appropriate protocol and experience under local anesthesia. Design: A retrospective review of subjects undergoing first branchial arch vestige excision utilizing local anesthesia was conducted (2017-2021). Demographics were recorded, including age, sex, comorbidities, vestige location, presence of tracts, post-operative complications, and significant associations. Results: A total of 178 subjects were identified for inclusion. The mean patient age during the procedure was 18.4 ± 38.3 months. A total of 34 patients presented with a current or prior comorbidity (24.7%). The most common location of the branchial remnant was the preauricular region (79.2%). Most patients were without complication (96.1%). Secondarily developed branchial anomalies were significantly associated with complications as compared to congenital anomalies (22.2% vs 3.0%, P < .042). Additionally, patients with a past medical history were significantly more likely to develop a post-operative complication (71.4% vs 22.6%, P < .13). Conclusion: In-office branchial remnant removal is a safe procedure in the young pediatric patient. Complication rates are low; patients with a significant past medical history may be more likely to incur postoperative complications. Additionally, patients with secondary vestige development may also be more likely to develop complications. Further in-office procedures are encouraged.

Diagnostic Challenges of Uncommon Paediatric Head and Neck MassesA Case Series

Paediatric head and neck masses pose diagnostic challenge to the clinicians owing to the wide spectrum of lesions including congenital (developmental), inflammatory and neoplastic lesions. In this case series, uncommon paediatric head and neck mass lesions that were diagnosed in a tertiary care hospital over a period of three years from January 2017 to December 2019, had been included, emphasizing on the diagnostic challenges encountered. First case was of Cervical Chondrocutaneous Branchial Remnant (CCBR) that was misdiagnosed as branchial cyst clinically. Second case was a lymphoepithelial cyst that masqueraded as an acute suppurative lymphadenitis in Fine Needle Aspiration Cytology (FNAC) due to florid inflammation. Third case was an aggressive poorly differentiated malignant neoplasm of left nasal cavity namely Nuclear protein in Testis (NUT) carcinoma that had to be differentiated from several other small round blue cell tumors. Fourth was a case of lipoblastoma which could be mistaken for myxoid liposarcoma. The last two cases were vascular tumors, one of them was juvenile capillary hemangioma with a benign clinical course while the other was an intermediate grade tumor namely kaposiform hemangioendothelioma. A wholesome clinical, radiological and pathological evaluation will help to solve the diagnostic dilemmas in this group of lesions.

Dyspnoea and large‐volume pleural effusion secondary to a cyst involving the cranial mediastinum in a cat

AbstractA 7‐year‐old female spayed domestic shorthair cat presented for dyspnoea and haemoptysis. Point‐of‐care ultrasound revealed pleural effusion. Fluid analysis noted proteinaceous fluid rich in small lymphocytes. A mediastinal mass was present on radiographs. CT revealed a fluid attenuating structure within the left thyroid gland. Right‐sided thyroid tissue was not identified. A fluid attenuating structure with associated amorphous soft tissue was present within the mediastinum. Aspirates were consistent with cystic fluid. A surgical cystectomy was performed. Histopathology of the left thyroid structure revealed a cystic thyroid follicular adenoma. The cystic structure involving the cranial mediastinum was suspected to represent an ectopic parathyroid cyst. Alternative differentials such as a branchial remnant could not be ruled out. Immunohistochemistry of the ectopic endocrine tissue associated with the cyst was negative for thyroglobulin and calcitonin. Parathyroid hormone immunohistochemistry was unavailable for confirmation. Post‐operative hypothyroidism and hypocalcemia were medically managed. Surgical cystectomy resulted in the resolution of pleural effusion.

Cervical chondrocutaneous branchial remnant: A rare second branchial arch anomaly

Abstract Cervical chondrocutaneous branchial remnants are rare second branchial arch remnants which present in children as small, slow-growing nodules in the lower third of the neck anterior to the sternocleidomastoid muscle. They are most commonly unilateral and do not penetrate deeper than the SCM fascia. They are treated with complete surgical excision for cosmesis and pathologic diagnosis. We present a case of a right-sided CCBR in a three-year-old male treated with complete surgical excision.

Unilateral cervical chondrocutaneous branchial remnant in Korean: A case report

Background: Compared to the frequency of occurrence of pre-auricular skin tag, cervical chondrocutaneous branchial remnants is one of congenital, benign neck masses that is very rare all over the world. Most of these rare anomalies are reported in case reports and especially, rare cases of unilateral cervical chondrocutaneous branchial remnants have been reported in Korean. Materials & Methods: A 9-year-old male patient visited the hospital on September 2017 for a rod-shaped mass. As a simultaneous diagnosis and treatment method, complete surgical excision was executed. Results: Excised mass was 0.5cm in diameter, 1.2cm in. Histologically, a hyaline and elastic cartilage was found in the core. As a family history, the same remnant was found in the right Anterior neck area of his mother. Conclusion: In this case, it is possible to diagnose and treat simply at the same time and even an optimal aesthetic result can be obtained. Key Words: Cervical Chondrocutaneous Branchial Remnant, Skin tag, Choristoma

A Case of Congenital Cervical Chondrocutaneous Branchial Remnant

A Case of Congenital Cervical Chondrocutaneous Branchial Remnant

Minimally Invasive Laryngoscopically Assisted Management of an Enlarging Fourth Branchial Remnant

Abstract Introduction: Third and fourth branchial cleft remnants usually present as cysts, sinuses, or fistulae. In this video, we show an exceptional case of an infected large fourth branchial cle...

A Case of Cervical Chondrocutaneous Branchial Remnant Comprised of Hyaline Cartilage

A Case of Cervical Chondrocutaneous Branchial Remnant Comprised of Hyaline Cartilage

Marsupialization and sclerotherapy with povidone iodine and ethanol of a branchial remnant cyst in an Arabian filly.

ABSTRACTBranchial remnant cysts are an uncommon cause of masses of the throatlatch area in horses. Two methods of treatment have been proposed in literature, both with complications. This manuscript proposes a method (marsupialization and sclerotherapy) for the treatment of a cyst in a 1.5-year-old Arabian filly. Diagnosis was made by ultrasonographic, radiographic and endoscopic examinations, revealing an anechoic fluid-filled structure and a well-defined capsule not in communication with other structures. After emptying the cyst, the skin was sutured circumferentially to the cyst wall; it was then flushed first with a solution of ethanol and povidone-iodine, then with sterile saline. Eight months after surgery, the filly had no recurrence of the cyst and the stoma was healed.

先天性頸部遺残軟骨例

先天性頸部遺残軟骨例

Cervical chondrocutaneous branchial remnant

Abstract Cervical chondrocutaneous branchial remnants are rare lesions which present on the lateral side of the neck, anterior to the sternocleidomastoid muscle. They have been recognized by various names since their discovery as a pathological entity, however they have been designated a distinctive term as of 1997. Although not yet confirmed, the true origin of these lesions has been under scrutiny for the past century, and scarcity of reported cases hinders this process. Treatment of these lesions is complete surgical excision. A case of a 4-year-old girl with a unilateral left sided cervical chondrocutaneous branchial remnant is presented.

A case of congenital cervical chondrocutaneous branchial remnant

A case of congenital cervical chondrocutaneous branchial remnant

Cervical chondrocutaneous branchial remnants – Report of 17 cases

Background/purposeCervical chondrocutaneous branchial remnants are congenital, benign and rare neck masses. These anomalies are limited in the literature, reported mostly as case reports.Cervical chondrocutaneous branchial remnant is always present at birth, and the lesion is usually unilateral. Understanding and treatment of cervical chondrocutaneous branchial remnants requires knowledge of the related embryology. MethodsFrom January 2005 to December 2008, 17 patients with mean age of 32 months (range from 2 months to 15 years) with CCBRs were treated at the Division of Pediatric Surgery, Department of Plastic and Reconstructive Surgery and Burns at the Institute for Mother and Child Health Care, Belgrade, Serbia. The following objections were recorded: sex, lesion side, surgical data, associated malformations and pathohistology findings. ResultsThere were 7 females and 10 males, 4 with bilateral presences. Five children had associated anomalies, as follows: vesicoureteral reflux, atrial and ventricular septal defect, ventricular septal defect, branchiootorenal syndrome and preauricular sinus.There was a positive family history in one patient. Fifteen patients (88%) were treated with complete surgical excision and no connections with deep underlying structures of the neck were found. There were no complications at surgery. No recurrence was found during follow-up. Histopathology analysis revealed both, hyaline and elastic cartilage. ConclusionCervical chondrocutaneous branchial remnants are rare anomalies arising from branchial arch, probably originally from remnants of first or second arch. Surgical excision is the treatment of choice. From our experience, we suggest surgical treatment early in childhood because of esthetic reason, simplicity of the intervention and low complication rate. Also, the abdominal ultrasound and cardiac examination is recommended because of associated anomalies.

Cervical chondrocutaenous branchial remnant: a case report

Cervical chondrocutaneous branchial remnants are rare lesions which are encountered at the lateral neck. The lesions always present at birth, and are located in the middle or lower third of the lateral neck with a significant prevalence of location anterior to the sternocleidomastoid muscle. The overlying skin is similar to the surrounding neck skin and the lesion is painless, lacking any inflammation or discharge. Simpe surgical excision is all that is required for treatment. We herein report a case of patient with unilateral condrocutaneous remnant.

Treatment of an 18‐year‐old mare for bilateral, branchial remnant cysts

SummaryThis report describes the treatment of an aged mare for bilateral, branchial remnant cysts by marsupialisation and sclerotherapy the cysts. Treatment to resolve the cysts was prolonged, but the mare had no long‐term complications.

Right-Sided Pyriform Sinus Fistula: A Case Report and Review of the Literature

Objectives. Pyriform sinus fistulae arise from disturbances in the development of the fetal third and fourth branchial pouches and are predominantly found on the left side. We report the rare case of a right-sided pyriform sinus fistula presenting as a lateral neck abscess. Study Design. Case report. Methods. A 24-year-old woman presented with a two-week history of right-sided neck abscess. A fluoroscopic sinogram revealed a fistulous tract extending from the abscess to the apex of the right pyriform sinus. It was determined that the fistula was likely a third or fourth branchial remnant, a rare right-sided finding. Chemocauterization of the fistulous tract with 40% trichloroacetic acid was used to successfully treat the patient. Results. Approximately 93–97% of branchial pouch anomalies are left sided. Treatment options include surgical excision and cauterization. Conclusions. Branchial cleft cyst and pyriform sinus fistula must be considered in the diagnosis of cervical abscess in either side of the neck.

32 Parotidectomy in children and young adults: a review of 10 cases

Introduction: Parotidectomy in children and young adults is uncommon and there is a paucity of studies in this area. Methods: We retrospectively analysed clinico-pathological profile of all cases of parotidectomy in patients under the age of 25 at York Hospital by one consultant over 15 years from 1994 to 2009. Results: A total of 10 cases (M:F = 1:1.5) were identified. Eight of them were under the age of 16 (median age 8.5 years, range 7 months to 24 years). The most common symptom was painless swelling and the mean duration of symptom was 2.4 years (3 weeks to 10 years). The CT scan was the most commonly undertaken investigation followed by fine needle aspiration. A superficial parotidectomy was performed in 7 cases, while a total parotidectomy with preservation of facial nerve was performed in 3 cases. The mean inpatient stay was 2.3 days (2–5 days). The histological diagnoses included 2 cases each of pleomorphic adenoma and branchial arch remnant fistula and 1 case each of sialadenitis, haemangioma, tuberculosis, cat scratch disease, lymphangioma and sarcoidosis. The histological diagnosis matched clinical diagnosis only in 50% of the cases. The most common type of complication was transient facial nerve weakness. Conclusion: A variety of conditions which are difficult to diagnose clinically can affect the parotid gland in children and young adults requiring surgical intervention. Parotidectomy can be performed in this age group with minimal morbidity. We discuss surgical anatomy and technique as well as literature review on each condition affecting the parotid gland.

Branchial remnant cysts of mature and juvenile horses

This clinical report describes 8 cases of branchial remnant cysts (BRC) in the horse. The horses presented with bimodal age distribution, with 5 cases in mature horses (age 8-21 years) and 3 in foals (age 1, 6 and 10 months). Mature cases presented for dysphagia or intermittent oesophageal obstruction (2/5), and retropharyngeal swelling (3/5), whereas respiratory stridor and visible mass were presenting complaints in the foals. Presence of a right-sided (5/8) or dorsally located (2/8) palpable retropharyngeal mass of 3-35 cm diameter was noted clinically; one left-sided mass was identified as an incidental finding at necropsy. Ultrasonography typically revealed a thick-walled cyst containing hypoechoic fluid with dependent hyperechoic masses consistent with blood clots. Radiographs and upper airway endoscopy were also consistent with a retropharyngeal mass. Fluid cytology revealed chronic haemorrhage in 6/8 cases, and squamous epithelial cells in one case. Histopathology in all cases demonstrated an epithelium-lined cyst with no smooth muscle or thyroid tissue. Two cases was subjected to euthanasia; one due to concurrent laryngeal anomalies and one due to financial constraints. The remaining 5 cases were treated via surgical excision. Post operatively, right laryngeal hemiplegia was observed in 4/5 cases. All previous reports of BRC in the horse have described juvenile individuals. Brachial remnant cyst should be considered a differential diagnosis for mature horses with masses of the throatlatch area and can be definitively diagnosed by the presence of squamous epithelium in aspirated fluid or by histopathology of the excised mass. Right recurrent laryngeal nerve damage is a common complication of surgery.

O.596 Surgical treatment of flrst and second branchial arches anomalies

Cervical chondrocutaneous branchial remnants are rare and unusual choristomas (dysgenetic tumor, originating from dislocated tissue). To get proper understanding of the etiology and consequently histology, knowledge of early embryologic processes from cartilage structures in the head and neck region is mandatory. A case of a 3 days old girl with a unilateral, cervical chondrocutaneous branchial remnant tumor in the lower half of the neck is presented.