An Unusual Presentation of A Branchial Cleft Cyst

Otolaryngology Case Reports
13 Mar, 2019 ,

This is a 70-year-old non-smoking gentleman presented with a subacute presentation of dysphagia and odynophagia. Physical examination revealed a right posterior oropharyngeal swelling. On imaging, he was found to have a 4.6cm cystic, right parapharyngeal mass abutting the prevertebral fascia. Fine needle aspirate suggested benign pathology. Surgical resection was pursued and final pathology was consistent with a branchial cleft cyst.

Source
Full content

Background
Branchial cleft cysts are common congenital head and neck masses predominantly presenting in a pediatric setting. Most branchial cleft cysts do not provide a diagnostic challenge as they have consistent physical locations and clinical presentation. This paper describes a rare case of branchial cleft cyst isolated in the parapharyngeal space. To our knowledge, this is the oldest presentation of a parapharyngeal space branchial cleft cyst in the literature.

Case
A 70-year-old non-smoking gentleman presented with a subacute presentation of dysphagia and odynophagia. Physical examination revealed a right posterior oropharyngeal swelling. On imaging, he was found to have a 4.6cm cystic, right parapharyngeal mass abutting the prevertebral fascia. Fine needle aspirate suggested benign pathology. Surgical resection was pursued and final pathology was consistent with a branchial cleft cyst.

Discussion
Benign congenital branchial cleft cysts should be considered in the differential diagnosis for parapharyngeal masses, regardless of age.