Radiology Teaching Files > Case 6948015

Contributed by: Radiology Residency Program Faculty & Staff, Northeastern Ohio Universities College of Medicine-Canton Affiliated Hospitals, Ohio, USA.
Patient: 29 year old female
History: 29 year old female with a left neck nodule.

Fig. 1: CT with IV Contrast
Findings: Fig. 1: A metallic marker was placed at the palpable area of abnormality at the left neck. Directly underlying thisis a 12 mm x 10 mm low attenuation nodule in the subcutaneous tissuesof the left parotid space just inferior to the parotid tail. This shows a thin rim of hyperattenuation.

Complex First Branchial Cleft Cyst

Surgical Excision on 10/11/06. 

Pathology: Ruptured epidermal inclusion cyst with florid chronic granulomatous reaction.  Comment:  It is possible that the findings represent a pre-existing branchial cleft cyst with diffuse squamous metaplasia.


First Branchial Cleft Cyst

- 7% of all branchial cleft cysts (BCCs)
- Location:
  > Work type I: Inferoposteromedial to pinna
  > Work type II: Angle of mandible to EAC
  > Work type III: Periparotid
- Sinus drainage to ear, skin
- Etiology: persistent cleft
- Usually of CSF density and intensity unless otherwise infected or traumatized
- Because second BCCs are so much more common, they probaly outnumber first BCCs in the periparotid location


Grossman, RI., Yousem, DM. Neuroradiology: The Requisites. 2nd Edition. Mosby, 2003.

Submitted by:Aakash D. Singh, M.D. PGY-V Radiology Resident

Barry McNulty, M.D. - Radiologist
Mercy Medical Center

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Additional Details:

Case Number: 6948015Last Updated: 10-15-2006
Anatomy: Face and Neck   Pathology: Benign Mass, Cyst
Modality: CTExam Date: 08-23-2006Access Level: Readable by all users
Keywords: first branchial cleft cystACR: 20.361

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