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Fulltext Branchial fistula--a review

Lee ST, Krishnan MM

Singapore Med J, 1991 Feb;32(1):50-2.
PMID: 2017707

Congenital branchial fistula and their embryology is well described in the literature. The accepted standard treatment method includes stepladder excision for extensive fistulas. This paper presents two cases (Case 1 and 2) which are embryologically typical of second and third arch origin respectively; and a third case (Case 3) which has not been previously described. Case 3 appears to be a hitherto unreported combination of first and second arch origin. Case 1 and 2 were treated via a standard stepladder excision approach. A different newer approach was utilised in Case 3, that is, stripping of the fistulous tract with Myer's vein stripper. Unlike the stepladder approach, this is simple and avoids extensive time consuming dissection. However, being a blind procedure, it is not generally advocated if vital structures exist in the proximity.

Matched MeSH terms: Branchioma/diagnosis*; Branchioma/radiography; Branchioma/surgery
Fulltext Follicular Thyroid Adenoma presented as Branchial cyst: Case report

Abdul Halim Shibghatullah, Wan Shah Jihan Wan Din, Ramiza Ramza Ramli

International Medical Journal Malaysia, 2008;7(1):1-5.
MyJurnal

Follicular adenoma defined as a well encapsulated benign neoplastic condition of thyroid follicles. We describe this interesting case of a boy presented with right sided neck swelling that was diagnosed as a branchial cyst but later after excision, the histopathology revealed follicular adenoma of the thyroid with hemorrhage and degenerative changes in the centre. To our knowledge, this is the first reported case of follicular thyroid adenoma presented as branchial cyst.

Matched MeSH terms: Branchioma
Fulltext Parotid lymphoepithelial cyst: a case report

Rahman, S., Shaari, R., Hassan, R.

Archives of Orofacial Sciences, 2006;1(1):71-75.
MyJurnal

A 48 years old Malay lady with a case of painless soft fluctuant swelling of left parotid gland is reported. The lesion was found to be a cystic lesion through the pre operative examinations and investigations. The cyst was completely excised, taking care not to injure the lower division of the facial nerve. Post recovery was uneventful with no defect of the facial nerve functions. The histologic picture confirmed that the cyst was lymphoepithelial cyst which is so called “branchial cyst”. Through the literature reviews of parotid lymphoepitelial cyst the discussions on prevalence, origin, diagnosis, histological finding, investigation and the modes of treatment are made. The ultra sound was found to be valuable in the pre operative evaluation of the parotid swelling furthermore it is non-invasive, harmless, painless and relatively quick.

Matched MeSH terms: Branchioma
Fulltext Second branchial arch fistula masqueraded as recurrent parotid abscess: a case report

Nurul Hana Mokhtar, Khairuddin Abdullah, Fairuz Mohd Ibrahim, Irfan Mohamad

Archives of Orofacial Sciences, 2018;13(1):50-53.
MyJurnal

Branchial apparatus anomalies usually manifest in teenage or early adult life. Infection complicates
second branchial pouch anomalies usually presented as a neck lump or discharging sinus. It is the most common
form of anomalies compared to another branchial pouch aberrant. However, it is extremely rare to find a
complete branchial fistula with both internal and external openings. Misdiagnosis usually occurs leading to
inappropriate and suboptimal treatment. Here, we report of a case of complete second branchial pouch fistula
and discuss the clinical presentation and surgical management of such lesion.

Matched MeSH terms: Branchioma
Nasopharyngeal Carcinoma with Cystic Cervical Metastasis Masquerading as Branchial Cleft Cyst: A Potential Pitfall in Diagnosis and Management

Sai-Guan L, Min-Han K, Kah-Wai N, Mohamad-Yunus MR

Iran J Otorhinolaryngol, 2017 Mar;29(91):117-120.
PMID: 28393061

INTRODUCTION: Most metastatic lymph nodes from head and neck malignancy are solid. Cystic nodes are found in 33% - 61% of carcinomas arise from Waldeyer's ring, of which only 1.8% - 8% originate are from the nasopharynx. Some cystic cervical metastases were initially presumed to be branchial cleft cyst. This case report aims to highlight the unusual presentation of cystic cervical metastasis secondary to nasopharyngeal carcinoma in a young adult. The histopathology, radiological features and management strategy were discussed.
CASE REPORT: A 36-year-old man presented with a solitary cystic cervical swelling, initially diagnosed as branchial cleft cyst. Fine needle aspiration yielded 18 ml of straw-coloured fluid. During cytological examination no atypical cells were observed. Computed tomography of the neck showed a heterogeneous mass with multiseptation medial to the sternocleidomastoid muscle. Histopathological examination of the mass, post excision, revealed a metastatic lymph node. A suspicious mucosal lesion at the nasopharynx was detected after repeated thorough head and neck examinations and the biopsy result confirmed undifferentiated nasopharyngeal carcinoma.
CONCLUSION: Cystic cervical metastasis may occur in young patients under 40 years. The primary tumour may not be obvious during initial presentation because it mimicks benign branchial cleft cyst clinically. Retrospective review of the computed tomography images revealed features that were not characteristic of simple branchial cleft cyst. The inadequacy of assessment and interpretation had lead to the error in diagnosis and subsequent management. Metastatic head and neck lesion must be considered in a young adult with a cystic neck mass.

Matched MeSH terms: Branchioma