Fourth branchial pouch anomalies are extremely rare and only a few such cases showing sinuses and cystic masses have been reported in the literature. We describe a patient who presented on the third day of life with cystic neck swelling of fourth branchial pouch origin giving rise to respiratory obstruction and stridor. Despite repeated aspiration of the cystic mass to relieve respiratory obstruction, rapid recurrence of the mass continued to cause stridor and ultimately required surgical excision. The clinical, radiological, and histopathological findings of this unusual condition are discussed with a review of the literature.
A 36-year-old man presented with haemoptysis and his admission chest radiograph showed a large thin walled cystic lesion with an air-fluid level in the left lower lobe. The pathological diagnosis of the lesion, which was removed by a left lower lobe resection, was an intrapulmonary bronchogenic cyst.