Branchial Cleft Cyst Associated with Xanthogranulomatous Inflammation – An Unusual Case

Abstract

Rationale: Branchial cleft cysts are benign lesions that result from developmental defects arising from primitive branchial arches, cleft, and pouches. Xanthogranulomatous inflammation (XGI) is a mass forming lesion and its association with branchial cleft cyst is rare. Patient Concerns: A 23-year-old male presented with a soft, partially mobile, nontender swelling on the left side of submandibular area. His main concern was removal of pathology. Diagnosis: Computed tomography scan showed a well-circumscribed rounded cystic lesion suggestive of 2 nd branchial cleft cyst, which was histopathologically confirmed as branchial cleft cyst with XGI. Treatment: Complete surgical excision was done under general anaesthesia and the lesion was removed in toto. Outcomes: Patient’s postoperative course was uneventful and he was discharged from the hospital on the 4 th postoperative day. Take-away Lessons: Diagnosis of branchial anomalies should always be considered while dealing with lateral neck swellings and XGI associated with branchial cleft cyst should be carefully investigated and treated.

Current approach to branchial remnants in the neck

“…Another important aspect is regarding the existence of true branchiogenic carcinoma, which is still controversial and remains a diagnosis of exclusions unless detecting the primary site [ 25 ]. Moreover, the differential diagnosis should include extremely rare circumstances, such as associating xanthogranulomatous inflammation [ 26 ]. Vazquez Salas et al recently published one of the most comprehensive reviews of FNAB cytology diagnosis of uncommon cystic lesions in the head and neck region [ 27 ].…”

“…Moreover, the differential diagnosis should include extremely rare circumstances, such as associating xanthogranulomatous inflammation [26].…”