Branchial Cyst Research Articles

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 & 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.

13-month-old female with left neck swelling.

A 13-month-old female was brought to the emergency department by her mother for 2 days of left neck swelling (Figure 1). Per her mother, the patient had developed progressive swelling and erythema after scratching the area over the last week. Otherwise, she was asymptomatic with normal vital signs. Before the patient's swelling, there had been a “dimple” at the area since birth. A point-of-care ultrasound was performed, demonstrating a 2.1 × 2.3 × 2.1 cm cystic and heterogeneous structure (Figure 2). Infected Branchial Cleft Cyst. Branchial cleft anomalies are remnants of branchial cleft mucosa during embryogenesis.1, 2 Incomplete involution of the mucosa create vestigial cysts, sinuses, and/or fistulas. There is a predilection for branchial cleft anomalies on the left side, more common in females, and second branchial cleft anomalies are the most common.3 Branchial cleft cysts present as a painless soft tissue mass around the anterolateral neck, along the anterior sternocleidomastoid muscle. If infected, they can become swollen and tender. Rarely, the cyst can lead to complications of airway compromise and glossopharyngeal and hypoglossal nerve compression due to mass effect.4 Clinical and radiological diagnostics can raise suspicion for branchial cleft cysts. Definitive diagnosis is made with cyst excision and histological examination, demonstrating a cystic cavity lined by epithelium and underlying connective tissue showing germinal centers.4 Other diagnoses to consider for pediatric superficial neck masses are lymphadenopathy, thyroglossal duct cyst, or dermoid cyst. Conservative treatment of needle aspiration, incision and drainage, and injection of sclerosant agents may be trialed, but recurrence is common.1-4 Definitive treatment is surgical excision.

An infant with congenital heart defects and proteinuria: a case report

BackgroundBranchio-Oto-Renal (BOR) Syndrome is a rare autosomal disorder with a wide variety of clinical manifestations and a high degree of heterogeneity. Typical clinical manifestations of BOR syndrome include deafness, preauricular fistula, abnormal gill slits, and renal malformations. However, atypical phenotypes such as congenital hip dysplasia, congenital heart anomaly or facial nerve paresis are rare in BOR syndrome, and this might be easily misdiagnosed with other congenital disorders.Case presentationWe report a 5-month-old boy of BOR syndrome with "congenital heart defects and proteinuria" as clinical features. Initially, as this case mainly presented with symptoms of recurrent respiratory infections and was found to be with congenital heart disease and proteinuria at the local hospital, but he only was diagnosed with congenital heart disease combined with pulmonary infection and anti-infective and supportive treatment was given. Subsequently, during the physical examination at our hospital, left side preauricular pit and branchial fistulae on the right neck were found. Subsequent evaluation of auditory brainstem response and distortion product otoacoustic emission were revealed sensorineural hearing impairment. Results of renal ultrasonography showed small kidneys. Genetic analysis revealed a microdeletion at chromosome 8q13.2-q13.3 encompassing EYA1 gene, this patient was finally diagnosed with BOR syndrome. Then, this patient received transcatheter patent ductus arteriosus closure and hearing aid treatment. Proteinuria, renal function and hearing ability are monitoring by nephrologist and otologist. The patient is currently being followed up until 3 months after discharge and his condition is stable.ConclusionCareful physical examination, detailed history and the implementation of diagnostic laboratory tests can reduce the incidence of misdiagnosis. Genetic sequencing analysis of patients is a key guide to the differential diagnosis of BOR syndrome.

An intriguing case of a complete 2nd arch branchial fistula: a portal to the infectious world

Complete 2nd arch branchial fistulae are very rare congenital anomalies of head and neck. They arise due to the incomplete obliteration of the branchial clefts during embryonic period. In this article we report a case of type IV 2nd branchial cleft anomaly in a 15-year-old female. Explicit knowledge regarding its development, anatomy and accurate diagnosis, skillful complete excision of the tract is paramount in its management and to prevent recurrence.

Open meningocele associated with a cervical spinal arachnoid cyst and Arnold Chiari malformation type II, a case report

Introduction: Spina bifida is a congenital malformation involving the vertebral spine with different presentations ranging from occult defects to large cutaneous defects exposing tissue and nerves.
 Case report: Here we describe a patient who had open spina bifida with exposure of the nerve roots, which seemed to be functional on physical examination. A few days after surgery for the closure of the lumbosacral defect, the patient presented with severe respiratory distress and quadriparesis. Magnetic resonance imaging showed a cervical arachnoid cyst and Arnold Chiari type II malformation requiring a second surgical procedure consisting of decompression of the bones and ligaments at the craniospinal junction and microsurgical fenestration of the spinal arachnoid cyst.
 Discussion: To our knowledge, spinal arachnoid cysts are a rare entity in pediatric
 patients. On the other hand, spinal dysraphism, of which myelomeningocele is the most frequent congenital form, is common. In a literature search, no previous reports were found of cases similar to ours with open spinal dysraphism with these specific anatomical characteristics associated with an arachnoid cyst in the cervical spine and Arnold Chiari malformation.
 Conclusion: Spinal dysraphism includes different complex disorders. Full spinal magnetic resonance imaging is recommended for the early detection of associated conditions.

Lateral Neck Malignant Cyst

Branchial cysts are the most common lesions in lateral neck cysts. Rare branchial cysts are associated with malignant tumors metastatic from the thyroid gland. Occult thyroid papillary carcinomas often present as a solid mass in the lateral neck, with only a few cases revealing a branchial cyst as the initial manifestation.

Cervical Cyst – A Tale of the Unexpected

Abstract Primary hyperparathyroidism (PHPT) is the third most common endocrine disease after diabetes and osteoporosis. It is more common in women and its prevalence increases with age. PHPT is associated with parathyroid adenoma or cancer or paraneoplastic parathyroid hormone (PTH) production. PHPT can be asymptomatic or present with nephrolithiasis, peptic ulcers, pancreatitis, bone lesions and rarely – as a palpable formation in the cervical area. We present a 73-year-old female patient with cystic cervical lesion with high levels of PTH in the evacuated fluid contents. We discuss the differential diagnosis and the diagnostic algorhythm in cystic cervical lesions.

A Rare Presentation of Second Branchial Cleft Cysts in Adult Patient: Case Report with Literature Review

Second branchial cleft cysts are the most common type of branchial cleft cysts as they make up approximately 95% of all cases. These are congenital conditions that occur in the upper lateral neck just anterior to the sternocleidomastoid muscle and caused by fluids filling spaces during early embryonic development. We present a case of atypical presentation of second branchial cleft cysts in 40 year’s patient, A surgical intervention was performed with complete excision of the cysts. Many of branchial cleft cysts would go unnoticed. However, upper respiratory tract infection can cause a sudden and significant increase in the size of the cyst because of the lymphoid tissue beneath the epithelium, The Differential diagnosis would include lymphadenopathy, lipoma, nerve sheath tumor, inflammatory lesions, carotid body tumor, external laryngocele, cystic hygroma, metastatic squamous cell carcinoma, tuberculosis-related, HIV-related lymphadenopathy, sarcoidosis, cat-scratch disease, lymphoma, and papillary thyroid carcinoma metastasis. Surgical excision is the only known treatment for second branchial cleft cysts; moreover, a complete removal of second bronchial cyst cleft is of paramount importance since it is key to preventing any recurrence of the disease.

Professor SHAO Jing-ming's clinical experience of fire needling for surgical diseases

Professor SHAO Jing-ming's clinical experience of fire needling for bone-joint tuberculosis, tuberculous cervical lymphadenitis, ganglion cyst and thyrophyma is summarized. Professor SHAO used fire needling to treat bone-joint tuberculosis. The acupoints included ashi points and nearby acupoints, particularly local opposite acupoints (Neixiyan [EX-LE 4] and Dubi [ST 35], Yinlingquan [SP 9] and Yanglingquan [GB 34], Xuehai [SP 10] and Liangqiu [ST 34]), and for the patients with severe yin-cold syndrome, Yanghe decoction was additionally used. For tuberculous cervical lymphadenitis, fire needling was used at different stages. In the early stage, the nucleus was punctured with fire needling; in the middle stage, the pustule was punctured with fire needling combined with cupping; in the late stage, the fire needling was inserted into the fistula or sinus tract, and the surrounding granulation tissue was treated with horizontal penetrating needling. For ganglion cyst, fire needling combined with centro-square needling was applied. For thyrophyma, the surrounding needling with filiform was used; for simple thyroid mass and thyroid nodule, the surrounding needling with fire needling was used.

아가미-귀 증후군 환자에서 발견된 양측 제3형 새열기형 1예

Branchio-otic (BO)-syndrome is a relatively uncommon genetic disease, and is characterized by branchial fistulae, congenital preauricular fistulae, and anomalies of the pinnae, external, middle, and inner ears, accompanied by hearing loss. The phenotype varies, so that degree of hearing loss and the type of branchial fistulae vary depending on the patient. Branchial cleft anomaly is common feature of BO syndrome (63%), and most of them are 2nd branchial cleft anomaly. There have been no reports of BO syndrome with 3rd or 4th branchial cleft anomaly published in literature. We report a case of bilateral 3rd branchial cleft anomaly in a 22 year-old male patient with BO syndrome, who treated with chemical and electrocauterization therapy, with a review of literatures.

BRANCHIAL CLEFT CYST: REPORT OF TWO CASES

Branchial cleft cyst (BCC), also known as lateral cervical cyst, usually presents as a circumscribed swelling in the lateral region of the neck. We report 2 cases of BCC. A 31-year-old woman and a 26-year-old man presented circumscribed, unilateral swelling with painful symptoms. On palpation 1 was soft in consistency and the other was hardened. Fan beam computed tomography images were obtained in both cases and showed hypodense, well-circumscribed images. One was localized below the platysma muscle and the other in the submandibular region in intimate contact with the submandibular gland. The lesions were surgically excised. Microscopic evaluation confirmed the final diagnosis of branchial cleft cyst. No recurrences were observed in clinical follow-up. Clinicians should consider branchial cyst when evaluating swelling in the neck.

Branchial Cyst a Delayed Presentation - Case Report

Branchial Cyst a Delayed Presentation - Case Report