Prevalence of cystic metastases in a consecutive cohort of surgically removed branchial cleft cysts

Malignancy and “Violated Neck” Rates in Consecutive Cohort of 79 Adult Patients With Solitary Cystic Neck Mass—Lessons Learned and Recommendations for Clinical Practice Guidelines

“…This is primarily related to the inherent difficulty in predicting malignancy. 1,15 Generally, SCNM is classified into 3 main categories: benign lesions (eg, BCA, TDR, dermoid cyst, cystic lymphadenitis); primary cancers (eg, primary TDR carcinoma, primary branchiogenic carcinoma, dermoid cyst carcinoma); and metastasis (eg, head and neck cancer, gastrointestinal cancer, breast cancer, CUP). 2 Failure to detect malignancy often leads to surgical contamination of the neck before definitive treatment, that is, "violated neck."…”

“…Considering its complex histologic spectrum, SCNM often creates diagnostic uncertainties in clinical practice. This is primarily related to the inherent difficulty in predicting malignancy 1,15 . Generally, SCNM is classified into 3 main categories: benign lesions (eg, BCA, TDR, dermoid cyst, cystic lymphadenitis); primary cancers (eg, primary TDR carcinoma, primary branchiogenic carcinoma, dermoid cyst carcinoma); and metastasis (eg, head and neck cancer, gastrointestinal cancer, breast cancer, CUP) 2 .…”

“…13,14 Failure to predict malignancy leads to unnecessary breaching of the deep neck spaces to perform a biopsy. Hammarstedt Nordenvall et al 15 reported a malignancy rate of 3.3% in adult patients who underwent surgical treatment for BCA. Surgical contamination (eg, excisional or incisional biopsy) of the neck before definitive treatment remains controversial.…”