Bilateral cervical chondrocutaneous branchial remnants

Abstract

Rationale: Cervical chondrocutaneous branchial remnants are rare, benign, congenital anomalies, frequently seen bilaterally. Patient concerns: Here, we report the case of a 4-month-old female infant who presented with bilateral lower neck skin tag since birth. Diagnosis and Interventions: The patient underwent mass excision. The final pathological diagnosis was bilateral cervical chondrocutaneous branchial remnants with hyaline cartilage. Outcomes: No complications were observed after excision. One-year follow-up revealed no recurrence. Lessons: Bilateral chondrocutaneous branchial remnants are rare anomalies. They are often associated with cardiac or genitourinary abnormalities. Therefore, additional preoperative imaging of the abdomen and heart are recommended.

Cervical chondrocutaneous remnant: a case report

“…Since only the ear, epiglottis, corniculate cartilage, and part of the arytenoid cartilage are elastic in nature, the presence of elastic cartilage would suggest an auricular (first or second branchial arch) source [ 15 ]. In contrast, the presence of hyaline cartilage in the mass specimen of our patient excludes an auricular origin and suggests a cervical origin from the second or lower branchial arches [ 14 ]. Therefore, it is postulated that our patient’s cervical chondrocutaneous branchial remnant might have resulted from incomplete obliteration of the second or lower branchial arches.…”

“…The other theory suggests that cervical chondrocutaneous branchial remnants originate from the second and lower branchial arches, which contribute to the formation of most cervical structures [ 14 ]. Even further, those who claim cervical chondrocutaneous branchial remnants are of a branchial origin hypothesize that they arise from the primordial laryngeal remnants of the second and third branchial arches [ 2 ].…”

A Hump-like Neck Mass in a Child

“…It is also known as congenital cartilaginous rest of the neck, wattle, cervical auricle, or accessory tragus, and represents an uncommon, congenital, cartilaginous choristoma on the cervical area. [2][3][4] To date more than 136 cases have been reported, of which male sex is predominant (male vs female, 1.67:1), and unilateral CCBR (87.5%; left vs right, 1.64:1) is more common than bilateral CCBR (12.5%). 2 It may originate from the remnant of the second or lower branchial arch or pluripotent cell rests.…”

“…2 It may originate from the remnant of the second or lower branchial arch or pluripotent cell rests. 2,3 Generally, CCBR presents as an asymptomatic skin-colored protuberant mass with soft or cartilage-like texture and hairy surface, and involves the inferior third of the lateral neck, particularly along the anterior border of the SCM. [1][2][3][4][5] The incidence of associated anomalies is 11.8%-76.5% of patients with CCBR, with genitourinary, digestive, auditory, and cardiovascular anomalies being more common.…”

“…2 There is no correlation between associated anomalies and unilateral vs bilateral CCBR. 3 Ultrasonography and computed tomography (CT) have been used for preoperative evaluation of CCBR. These and other imaging studies may also be useful in assessing for associated anomalies, in addition to a detailed physical examination.…”