Radiology Teaching Files > Case 39255

Contributed by: Ed Weinberger, Radiologist, Seattle Children's Hospital & Regional Medical Center, Washington, USA.
Patient: 10 year old female
History: 10 Y/O female with mass protruding near the left tonsil.

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Findings: Low density cystic structure anterior to the left sternocleidomastoid at the level of the hyoid bone. It courses medially, passing between the internal and external carotid arteries. It ends in the pharyngeal space at the level of the oral cavity.
Diagnosis: Branchial cleft cyst
Discussion: Differential diagnosis of cystic neck lesions includes congential and acquired: Congenital: branchial cleft cysts, thyroglossal duct cysts, and cystic hygromas (rarely, thymic and cervical brnchogenic cysts).Most branchial cleft cysts are of type II (95%) such as this one. Second branchial cleft cysts are positioned anterior to the SCM, are homogeneously hypoattneuated, have a thin enhancing rim. They may course medially in between the ECA and ICA, and end in the parapharyngeal space, as this one.They clinically present between the 1st and 4th decade of life.
References: Koeller, KK, Alamo L, et al. "Congenital Cystic Masses of the Neck: Radiologic-Pathologic Correlation" Radiographics 19:121-146, 1999.
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Additional Details:

Case Number: 39255Last Updated: 12-17-2002
Anatomy: Other   Pathology: Other
Modality: CTExam Date: 12-17-2002Access Level: Readable by all users

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