Well-circumscribed Soft Tissue Research Articles

PMON85 Co-occurrence of Carotid Body Tumor, Meningioma and Schwannoma in a Symptomatic Patient, Incidental Findings Vs Genetic Syndrome: A Case Report

Abstract Carotid body tumors, also known as chemodectomas/paraganglionomas; are rare neuroendocrine tumors that arise from parasympathetic ganglionic cells. They are usually benign with incidence of malignancy is <10%. In majority of cases, tumors are asymptomatic and found incidentally on clinical exam or radiological imagining. Their association with other non-neuroendocrine tumors as seen in present case; has not been well documented in literature. Case presentation 43 y/o female with PMH of GERD, obesity, asthma and anxiety disorder who came to endocrine clinic for left middle thyroid lobe nodule(0.9×0.6×0.6cm) evaluation; incidentally noted to have a multilobulated heterogeneous hypo echoic and iso-echoic mildly vascularized solid nodular mass (3.46×1.83×1.93 cm) in the left carotid bifurcation area; splaying the common and the internal carotid arteries on US. Review of systems was positive for left sided neck pain, intermittent palpitations, headaches, anxiety, and sleep disturbances. Clinical exam was remarkable for thyromegaly and a palpable non-tender 3cm left neck mass with no cervical lymphadenopathy. Initial labs were notable for mild elevation of chromogranin A (108.4 ng/ml) with normal levels of TSH, free T3, free T4, plasma metanephrines and 24-hour urinary metanephrines. Considering patient's persistent symptoms; plasma catecholamines levels were done and were negative. MRI soft tissue neck confirmed 2.8 cm lobular mass suggestive of paraganglioma. Metastatic work up was negative. Patient was referred for genetic testing considering young age and to rule out hereditary disorders. Interim, patient presented to the ED with complain of sudden onset lumbar backache without sphincteric involvement; neurological exam was unrevealing but on MRI lumbar spine found to have a 5.7×4.8×4cm lobulated well-circumscribed homogeneous soft tissue mass suggestive of schwannoma. Cervical and thoracic spine imaging was unremarkable. MRI brain showed a 1.1cm enhancing mass in right Meckel cave suggestive of meningioma. PET-DOTATATE scan was performed that revealed left neck mass as intensely avid, Right petrous apex mass as moderately avid and lumbar mass as not avid at all, consistent with the diagnosis of paraganglionoma, meningioma and schwannoma respectively. No evidence of DOTATATE avid nodal/ distant metastatic disease was found. Initially a hereditary etiology was suspected but genetic testing including (VHL, NF1/2, SDHD, SDHB) came back negative. Case was discussed with multidisciplinary teams; Neurosurgery service recommends conservative management of both meningioma and schwannoma at the moment considering benign course. Regarding paraganglioma, as tumor is non-secretory on repeated work up; sympathetic blockade is not warranted and patient is scheduled for pre-op embolization and surgical resection by Head and Neck surgery. Conclusion Paraganglionomas are generally benign non-secretory tumors that usually occur with other neuroendocrine tumors both as hereditary syndromes and sporadic cases. But their association with non-neuroendocrine tumors is mere incidental or has a genetic causation; is still unclear and warrants further research. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

PMON85 Co-occurrence of Carotid Body Tumor, Meningioma and Schwannoma in a Symptomatic Patient, Incidental Findings Vs Genetic Syndrome; a case report.

Abstract Carotid body tumors, also known as chemodectomas/paraganglionomas; are rare neuroendocrine tumors that arise from parasympathetic ganglionic cells. They are usually benign with incidence of malignancy is <10%. In majority of cases, tumors are asymptomatic and found incidentally on clinical exam or radiological imagining. Their association with other non-neuroendocrine tumors as seen in present case; has not been well documented in literature. Case presentation 43 y/o female with PMH of GERD, obesity, asthma and anxiety disorder who came to endocrine clinic for left middle thyroid lobe nodule(0.9×0.6×0.6cm) evaluation; incidentally noted to have a multilobulated heterogeneous hypo echoic and iso-echoic mildly vascularized solid nodular mass (3.46×1.83×1.93 cm) in the left carotid bifurcation area; splaying the common and the internal carotid arteries on US. Review of systems was positive for left sided neck pain, intermittent palpitations, headaches, anxiety, and sleep disturbances. Clinical exam was remarkable for thyromegaly and a palpable non-tender 3cm left neck mass with no cervical lymphadenopathy. Initial labs were notable for mild elevation of chromogranin A (108.4 ng/ml) with normal levels of TSH, free T3, free T4, plasma metanephrines and 24-hour urinary metanephrines. Considering patient's persistent symptoms; plasma catecholamines levels were done and were negative. MRI soft tissue neck confirmed 2.8 cm lobular mass suggestive of paraganglioma. Metastatic work up was negative. Patient was referred for genetic testing considering young age and to rule out hereditary disorders. Interim, patient presented to the ED with complain of sudden onset lumbar backache without sphincteric involvement; neurological exam was unrevealing but on MRI lumbar spine found to have a 5.7×4.8×4cm lobulated well-circumscribed homogeneous soft tissue mass suggestive of schwannoma. Cervical and thoracic spine imaging was unremarkable. MRI brain showed a 1.1cm enhancing mass in right Meckel cave suggestive of meningioma.PET-DOTATATE scan was performed that revealed left neck mass as intensely avid, Right petrous apex mass as moderately avid and lumbar mass as not avid at all, consistent with the diagnosis of paraganglionoma, meningioma and schwannoma respectively. No evidence of DOTATATE avid nodal/ distant metastatic disease was found. Initially a hereditary etiology was suspected but genetic testing including (VHL, NF1/2, SDHD, SDHB) came back negative. Case was discussed with multidisciplinary teams; Neurosurgery service recommends conservative management of both meningioma and schwannoma at the moment considering benign course. Regarding paraganglioma, as tumor is non-secretory on repeated work up; sympathetic blockade is not warranted and patient is scheduled for pre-op embolization and surgical resection by Head and Neck surgery. Conclusion Paraganglionomas are generally benign non-secretory tumors that usually occur with other neuroendocrine tumors both as hereditary syndromes and sporadic cases. But their association with non-neuroendocrine tumors is mere incidental or has a genetic causation; is still unclear and warrants further research. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

18F-FDG PET/CT in Bilateral Breasts Metastasis From Ovarian Carcinoma.

Ovarian carcinomas generally metastasize within the peritoneal cavity due to exfoliation of malignant cells from primary tumor. Metastasis to the breasts is an unusual event and may mimic primary neoplastic disease. Usually, breast metastasis presents as a single isolated, well-circumscribed soft tissue lesion, and serous papillary carcinoma is the most common type of ovarian tumor that can metastasize to the breast. Concurrent bilateral breast metastasis is rare event. We present a follow-up case of metastatic carcinoma ovary, demonstrating FDG-avid soft tissue density masses in the bilateral breast parenchyma along with bilateral axillary lymphadenopathy, biopsy of which revealed metastatic deposits from carcinoma ovary.

Myofibroblastic sarcoma of the oral cavity: a diagnostic dilemma and report of two cases

Introduction: Myofibroblastic sarcoma is designated as a low-grade malignancy, commonly affecting the deep soft tissue of the head and neck. Despite being classified as low-grade, myofibroblastic sarcoma with high-grade features have been reported. Observations: Two such cases affecting the oral cavity, which were diagnosed as different entities upon biopsy, were observed. Case 1 presented as multiple, well-circumscribed soft tissue swellings of the tongue and alveolar mucosa and was diagnosed as synovial sarcoma. Case 2 manifested as a large extensive osseous lesion of the maxilla and was diagnosed as an inflammatory myofibroblastic tumour. Conclusion: Myofibroblastic sarcoma with high-grade features remains a diagnostic dilemma due to its overlapping features with other spectra of fibroblastic/myofibroblastic tumours and lack of consensus regarding its classification as a separate entity. Establishing the definitive diagnosis requires adequate tumour sampling and a systematic clinicopathological approach.

Solitary vaginal paraganglioma with mature sacrococcygeal teratoma: a rare case report

BackgroundVaginal paraganglioma are rare, atypical, solitary tumors which originate from the female genital tract. Sacrococcygeal teratoma are also rare neoplasms which derive from one (or more) primordial germ cell layers. Here we report a unique case of vaginal paraganglioma with sacrococcygeal teratoma.Case presentationA 44-year-old female experienced paroxysmal hypertension, palpitations and dizziness for almost six years. Enhanced CT and MRI highlighted two abnormal soft tissue lesions located in the left vaginal wall and coccyx anteriorly, and Iodine-131 metaiodobenzylguanidine (131I-MIBG) demonstrated abnormal radioactive uptake in perineum area. Endocrine tests showed elevated plasma normetanephrine (NMN) and 24 h urine norepinephrine. There was a well-circumscribed soft tissue lesion of approximately 3.5 cm in the left lateral vaginal wall which could be palpated during bimanual examination, together with a 1.5 cm tumor in the posterior wall of the rectum. We completely resected the two lesions in stages with the support of a senior gynecologist and general surgeons. Postoperative histopathological examinations suggested the vaginal paraganglioma and mature sacrococcygeal teratoma. Targeted sanger sequencing for the 36 mostly common paraganglioma-related genes, with a depth of 1000x, revealed no mutations. Post-operatively, plasma NMN and 24 h urine norepinephrine returned to the normal range and her symptoms completely disappeared.ConclusionsWe reported an extremely rare case and the successful treatment of functional vaginal paraganglioma coexisting with adult sacrococcygeal teratoma.

Posterior Shoulder Pain - Baseball Pitcher

HISTORY: Patient is a 20 year old right handed college baseball pitcher with a past medical history of ulnar neuritis. He presented with a 4 month history of right-sided inferior periscapular pain after increasing his pitching speed and frequency. This pain initially occurred only with high velocity pitches but progressed to occur with all pitching and some overhead reaching activities. It was associated with a catching sensation but otherwise no mechanical shoulder symptoms or neurologic arm symptoms. He denied constitutional symptoms. PHYSICAL EXAM: General: Healthy appearing, athletic build. Inspection: No obvious asymmetry. Palpation: Non-mobile, minimally prominent mass approximately golf ball size in diameter, just inferior and medial to the inferior angle of the scapula. This was mildly tender without fluctuance. Musculoskeletal: Normal right shoulder ROM. No scapular dyskinesis. Neurologic: Normal right arm strength, sensation, and reflexes. Special Tests: Negative shoulder impingement signs. DIFFERENTIAL DIAGNOSIS: Elastofibroma dorsi Scapulothoracic bursitis Snapping scapula Lipoma Sarcoma or other tumor TESTS AND RESULTS: X-rays: Unremarkable. Ultrasound: Well-circumscribed solid soft tissue mass overlying the posterior 7th/8th ribs. MRI: 5.4 x 1 x 3.5 cm mass in the infrascapular region underlying the serratus anterior and latissimus dorsi. No rib erosion or extension into the intercostal musculature. FINAL DIAGNOSIS: Images favored a benign process. After waiting to complete the current season, the mass was excised. The mass was deep to the serratus anterior muscle and adhered to the 7th rib. Pathology demonstrated fibroblastic proliferation, likely reactive due to repetitive microtrauma. TREATMENT AND OUTCOME: No follow up imaging or additionally treatments were necessary. Six weeks after excision, patient was able to throw a baseball with no pain and return to off-season baseball training.

Leiomyoma of the Urinary Bladder: A Review and Update

Leiomyoma of the urinary bladder / leiomyoma of the ureter is a very rare benign tumour of smooth muscle origin which has been reported sporadically globally. Leiomyoma of the urinary bladder/ureter may be diagnosed incidentally during investigation of various conditions including infertility and hepatitis. Leiomyoma of the urinary bladder / ureter may manifest in female as well as in a male patient with non-specific symptoms including lower urinary tract symptoms / retention of urine, haematuria, loin pain/discomfort, urinary tract infections and cystitis. The general and systematic examinations may be normal but at times there may be a palpable mass within the area of the urinary bladder on bimanual examination but not always. There may occasionally be tenderness in the loin. The results of routine haematology and biochemistry blood tests would generally tend to be normal but there may be anaemia and impairment of renal function some cases of visible haematuria and obstruction of the ureter respectively. Ultrasound scan would tend to illustrate a well-circumscribed polypoidal soft tissue mass projecting into the urinary bladder or within the intramural area of the bladder. Intravenous urography would show a filling defect in the urinary bladder. CT and MRI scans of abdomen and pelvis with contrast would show a well-defined round mass in the area of the bladder which could be iso-tense to skeletal muscles on T1 and T2 weighted images and occasionally may show cystic areas of necrosis. Cystoscopy would show the lesion projecting into the urinary bladder at the specific area of the urinary bladder involved and at times the projecting lesion would be covered by normal looking urothelial mucosa and on other occasions when the lesion is large and in the area of a ureteric orifice the specific ureteric orifice would not be visualized. Diagnosis of leiomyoma of the urinary bladder / ureter would be confirmed upon histopathology and immunohistochemistry study features of trans urethral resection biopsies of the lesion which would tend to show smooth muscle spindled-cells with no evidence of atypia, or necrosis, or haemorrhage and associated with a low Ki67 index. Trans-urethral resection of the urinary bladder lesion tends to be undertaken for small to medium sized lesions with good outcome but this tends to be associated with about 18% recurrence rate that would require further resections or surgical excision to ensure complete removal of the lesion and no further recurrences. Surgical excision of the lesion including partial cystectomy, local excision / enucleation have been very effective for the treatment of larger leiomyomas with no reported recurrence so far; nevertheless, patients who undergo augmentation cystoplasty or total cystectomy and urinary diversion would need to cope with the functional problems related to the cystoplasty or urinary diversion. Differential diagnoses of leiomyoma of the urinary bladder / ureter include leiomyosarcoma, urothelial carcinoma and other malignant lesions affecting the urinary bladder. There is need for clinicians to explore minimal invasive surgery to treat patients who have leiomyoma of the bladder / ureter especially those who have multiple co-morbidities and the alterative management options that could be undertaken in multi-centre trials include: Cryotherapy, radiofrequency ablation, irreversible electroporation, high frequency ultrasound treatment and super-selective embolization of the arterial branch supplying the leiomyoma. Patients who develop ureteric obstructions would additionally require nephrostomy insertions or insertion of ureteric stents as a temporary measure to improve their renal functions.

Base of tongue schwannoma on a 22 year old lady: a rare case

Schwannomas are benign tumours arising from the Schwann cells. Around 25-45% schwannomas have been reported occured in head and neck region, but only 1% located intraoral. We report a case of 22 year old woman who presented with foreign body sensation in throat, dysphagia, change of voice, and snoring. There was a slowly growing, solitary, encapsulated, painless, mass on the tongue base. Microscopically, it had the typical features of schwannoma, the diagnosis being supported by a strong positivity for S-100 protein. Ki67 staining showed low proliferative index (<5%) indicated benign schwannoma. CT-scan of oropharynx demonstrated a well-circumscribed soft tissue density mass, oval shape, connected with the left portion base of tongue, homogenous, and strong enhancement mass. The entire mass was removed in general anesthesia with conservative surgical excision via trans-oral route, histopathologic reported consistent as schwannoma. The patient remained disease-free, without any residual problems. Although the rarity of schwannoma on the tongue base, this case highlights the importance of including it in the differential diagnosis of mass from the tongue base. To the best of our knowledge, our case is only the twentieth of schwannoma at the base of tongue that reported in the literature. <p> </p>

Scaphoid instability caused by a giant cell tumour of the tendon sheath: A case report

Giant-cell tumour of the tendon sheath (GCTTS) is a soft tissue tumour that may invade bone, causing an intrinsic osseous lesion or instability on radiographs. A case with scaphoid instability caused by a histologically-confirmed neighbouring GCTTS has rarely been described in the literature. No definite and radical method is available for the treatment of GCTTS. This report describes an unusual case of a 22-year-old woman who previously experienced a GCTTS in her right elbow, which was removed 10 years earlier. Currently, she presented with an enlarged painless right wrist mass with focal swelling. The mass has been present for 5 years. During the previous 6 months, she felt something pop and experienced pain with limited motion in her right wrist. Magnetic resonance imaging demonstrated a well-circumscribed soft tissue mass. Under general anaesthesia, complete surgical resection of the mass was undertaken. Histopathological examination revealed that the mass was a GCTTS. Less invasive leverage reduction with external fixator support and iliac crest bone autologous graft for treatment of carpal instability were performed. Radical resection combined with external fixator support and bone grafting can provide a new option for the treatment of carpal instability.

Lipoblasts in spindle cell and pleomorphic lipomas: a close scrutiny

The presence and frequency of lipoblasts (LPB) in spindle cell lipomas (SCL) and pleomorphic lipomas (PL) has never been studied in detail on a histologically, immunohistochemically and molecular genetically validated set of tumors. The authors investigated this feature by reviewing 91 cases of SCL and 38 PL. When more than 3 unequivocal LPB were found, the case was regarded as positive for the presence of LPB. All positive cases were then stained with CD34 and retinoblastoma (Rb) protein antibodies and tested by fluorescence in situ hybridization for MDM2 and CDK4 amplifications and the FUS gene rearrangements. The patients with SCL and PL containing LPB were 14 women and 47 men, the rest were of unknown gender. The cases usually presented as superficial, well-circumscribed soft tissue masses and most commonly occurred in the upper back and neck. CD34 was expressed in all cases, while Rb protein was consistently absent in all. Molecular genetic results, when available, were in concordance with the morphological diagnosis of SCL/PL. LPB were found in 37 (41%) cases of SCL and 25 cases of PL (66%). While in many cases they are inconspicuous, in some others they constitute a very prominent component of the tumor. It is important to be aware of this fact in order to avoid misinterpretation as liposarcoma.

Sonographic diagnosis of intraosseous epidermoid cysts of the calvarium

Sonographic diagnosis of intraosseous epidermoid cysts of the calvarium

Local recurrent vaginal aggressive angiomyxoma misdiagnosed as cellular angiomyofibroblastoma: A case report.

Aggressive angiomyxoma (AAM) and angiomyofibroblastoma (AMFB) are two rare types of mesenchymal tumors with overlapping clinicopathological features. In certain cases, the differential diagnosis between the two tumors is difficult even for experienced pathologists. The present study reported the case of a well-circumscribed soft tissue mass on the anterior wall of the vagina in a 25-year-old woman. The mass was initially removed without disturbance to the adjacent tissues. The histopathological features included spindle cells in inconspicuous myxoid stroma and a well-demarcated mass without evidence of invasion, which prompted the initial diagnosis of AMFB. After 2 years, a mass returned in the same area and a wide tumor excision was performed. The histopathological examination confirmed the final diagnosis of AAM upon review.

Giant Extrapleural Solitary Fibrous Tumor of the Thigh.

Giant Extrapleural Solitary Fibrous Tumor of the Thigh.

Magnetic Resonance Imaging Features of Schwannoma of the Sinonasal Tract.

The purpose of the study was to explore the characteristic magnetic resonance imaging (MRI) findings of schwannoma of the sinonasal tract. Eighteen patients with histopathologically confirmed sinonasal schwannoma underwent conventional MRI, and 12 had dynamic contrast-enhanced MRI studies synchronously. The morphology feature, signal intensity, enhancement degree, and time intensity curve (TIC) pattern of schwannomas were retrospectively analyzed. This entity appeared as a well-circumscribed, oval or fusiform soft tissue mass with a mean greatest diameter of 38 mm. Schwannomas exhibited isointense on T1-weighted image in 12 patients and hypointense in 6. On T2-weighted image, the lesions were heterogeneously isointense in 14 patients and hyperintense in 4. The lesions had heterogeneously moderate and marked contrast enhancement in 2 and 16, respectively. The mottled-, island-, and multicyst-like appearance were identified in 3, 4, and 11, respectively. Compared with inverted papilloma and lobular capillary hemangioma, the type I TIC is characteristic of schwannoma. A well-circumscribed mass displaying T2 intermediate signal intensity, marked enhancement, and type I TIC, with cystic changes, strongly suggests the diagnosis of sinonasal schwannoma.

Solitary fibrous tumor of the soft palate: A report of two cases.

Solitary fibrous tumors (SFTs) are a unique group of mesenchymal neoplasms of fibroblastic or myofibroblastic origin and are extremely rare in the oral cavity. The present study reported two additional cases of SFTs in the soft palate, along with the computed tomography characteristics, which demonstrated well-circumscribed soft tissue lesions with marked and homogenous enhancement. Following wide resection, one of the cases showed certain malignant pathological characteristics, including infiltration of mucinous gland, hypercellularity, nuclear atypia and weak positive staining for S-100. In our experience, SFTs should be considered as a differential diagnosis when a well-circumscribed and solid mass in the soft palate is identified.

Orbital solitary fibrous tumor: A report of two cases

Solitary fibrous tumor (SFT) is a rare spindle-cell neoplasm that can be found in the orbit. Here, we report two cases affected by orbital SFT. Both patients were female, aged 52 years and 59 years, respectively, and had experienced a painless unilateral orbital lesion. Computed tomography (CT) imaging revealed a well-circumscribed and contrast-enhanced soft tissue mass simultaneously. The tumors were located in the laterotemporal extraconal space of the right orbit and the inferior portion of the left orbit, respectively. Both patients underwent complete resection of their tumors. The histological findings showed alternating hypercellular and hypocellular areas composed of bland spindle cells with a fibrous stroma. The strong immunoreactivity for CD34 supported the diagnosis of orbital SFT. There was no recurrence at the 2-year and 3-year follow-up visits, respectively. SFTs should be considered in the differential diagnosis of an orbital tumor. The combination of a CT scan, histologic findings, and immunohistochemical staining will provide an accurate diagnosis. En bloc excision of the tumor is the mainstay of treatment in order to avoid recurrence.

Visual Diagnosis: A 31/2-year-old Boy With Sickle -Thalassemia and a Groin Mass

1. Aditi Bagchi, MD* 2. Ashraf Elnawawi, MD† 3. Swayam Sadanandan, MD‡ 1. *Resident (PGY-3), Pediatrics, The Brooklyn Hospital Center, Brooklyn, NY. 2. †Attending Physician, Department of Pathology, The Brooklyn Hospital Center, Brooklyn, NY. 3. ‡Associate Chairperson, Department of Pediatrics, Chief, Division of Pediatric Hematology and Oncology, The Brooklyn Hospital Center, Brooklyn, NY. * Abbreviations: CFP: : calcifying fibrous pseudotumor IMT: : inflammatory myofibroblastic tumor A 3½-year-old boy with a history of sickle β-thalassemia presents to the hematology/oncology clinic for evaluation of a mass in his left groin. The child’s mother had noted a small lump in his left inguinal region 2 years ago. At that time, the pediatrician recommended observing the lump and monitoring any progression. Subsequently, the family moved out of town and did not seek further medical attention until now. Two weeks ago, his mother thought the mass had grown in size and brought him to a nearby hospital for evaluation. He was prescribed a 5-day course of oral antibiotics for a presumed local infection. However, there was no significant change in the size of the mass; so his mother brought him to the hematology/oncology clinic. There is no history of groin pain or erythema, abdominal pain, fever, weight loss, or change in bowel or bladder habits. There is no history of trauma. The child was born at term after an uncomplicated pregnancy and delivery, but newborn screening indicated sickle cell disease. On further evaluation, his mother was found to have β-thalassemia trait and his father had sickle cell trait. The patient was diagnosed as having sickle β-thalassemia and placed on penicillin prophylaxis and folic acid supplementation. Since then, he has had four hospitalizations for febrile illnesses but no history of documented bacteremia. He has not had any vaso-occlusive crises. His motor milestones are appropriate for age, with the exception of speech delay. On physical examination, the child is well nourished …

Ossifying fibromyxoid tumor — Diagnostic challenge for a cytopathologist

Ossifying fibromyxoid tumor — Diagnostic challenge for a cytopathologist

Giant cell tumor of the tendon sheath: A rare case in the left knee of a 15-year-old boy

Localized forms of giant cell tumors are defined as giant cell tumors of the tendon sheath (GCTTS). GCTTS arises from the synovium of a joint, bursa or tendon sheath, and 85% of the tumors occur in the fingers. GCTTS in the knee is extremely rare. We report an unusual case of a 15-year-old boy who presented with an occult growing swelling and a 2-month history of infra-patellar pain in the left knee. Magnetic resonance imaging (MRI) demonstrated a well-circumscribed soft tissue mass in the infra-patellar fat pad posterior to the patella tendon. Excision biopsy was performed by surgical removal. Histopathological examination revealed that it was GCTTS. During the follow-up period, his recovery was propitious and there was no recurrence. Owing to its few and non-specific symptoms, and local recurrence varying from 9 to 44%, its proper, early diagnosis and appropriate treatment is necessary. The purpose for which we report the case is to emphasize the possibility of GCTTS where there is a mass with non-specific symptoms such as infra-patellar pain of the knee, and to avoid misdiagnosis where possible.

Type III Second Branchial Cleft Cyst

ABSTRACTCervical congenital cystic masses constitute an uncommon group of lesions usually diagnosed in infancy and childhood. Branchial cleft cysts are congenital lateral neck masses which manifest in the adolescents or in adulthood. They arise from the remnants of the branchial apparatus of embryonic life. Here, in this case, patient was presented with branchial cleft cyst at the age of 70 years. Computed tomography of neck showed well-circumscribed soft tissue mass extending from parotid region to lower cervical region with small ill-defined extension between internal and external carotid arteries which is pathognomonic of type III second branchial cleft cyst. Complete surgical excision was done. Histopathological examination confirmed the diagnosis of branchial cleft cyst.How to cite this articleChoudhary SV, Khadakkar SP, Harkare VV, Dhoke PR, Dhote KS, Kamal NP. Type III Second Branchial Cleft Cyst. Int J Head Neck Surg 2012;3(2):112-114.