Branchial cleft cyst arising within the parotid space is considered an extremely rare phenomenon. In contrast, cystic squamous cell carcinoma in the lateral neck is not an uncommon presentation of HPV-related head and neck cancer. Although they have singly been narrated in literature, simultaneous expression of these anomalies has yet to be reported. We describe a case of synchronous presentation of branchial cleft cyst of the right parotid gland and cystic metastatic squamous cell carcinoma of the left neck. These findings are discussed in light of the challenges in fine needle aspiration biopsy of cystic masses, and the risk of two distinct pathologic entities presenting as cysts in the head and neck.

Parathyroid cysts (PC) are infrequently encountered and characterize less than 1% of all head and neck masses. When present, PCs may present as a palpable neck mass and lead to hypercalcemia and rarely respiratory depression. Furthermore, the diagnostics of PCs is difficult as they can masquerade as a thyroid or mediastinal mass given their proximity. PCs are theorized to be a progression of parathyroid adenomas and often routine surgical excision is sufficient for cure. To our knowledge, there is no documented report of a patient with an infected parathyroid cyst that led to severe dyspnea. This case describes our experience of a patient with an infected parathyroid cyst presenting as hypercalcemia and airway obstruction.

No abstract

No abstract

Atrial fibrillation (AF) is a common cardiac arrhythmia that can be seen in hospitalized patients. It has been shown to be a major risk factor for cardioembolic stroke, and therefore patients are frequently started on lifelong anticoagulation. The majority of patients benefit from either cardioverison or pulmonary vein isolation ablation. We herein describe the case of a 58-yearold male with a past medical history of atrial fibrillation surgery who presented to hospital for elective atrial fibrillation ablation after failed medical therapy and persistent symptoms. A transesphageal echocardiogram (TEE) prior to the procedure demonstrated a left atrial appendage clot despite patient's compliance with apixiban. Subsequently, the patient is started on warfarin therapy with a heparin bridge. A TEE performed 6 weeks after discharge showed resolution of the left atrial appendage clot allowing the ablation procedure to be successfully performed.