RARE NECK SWELLING – BRANCHIAL CYST: A CLINICOPATHOLOGICAL CASE REPORT

Abstract

Background: Branchial cysts are benign congenital lesions arising from incomplete obliteration of the branchial apparatus, most often the second branchial cleft. They usually present as painless, slowly enlarging lateral neck swellings in children and young adults, although secondary infection can produce rapid, painful enlargement. Case presentation: We report a 14-year-old girl who presented with a painful, rapidly enlarging swelling on the left side of the neck of six weeks’ duration. Examination revealed a 5 × 4 cm cystic, fluctuant, transilluminant swelling in the upper part of the left anterior triangle. The lesion was completely excised under general anaesthesia; gross and histopathological examination confirmed a branchial cyst lined by stratified squamous epithelium with abundant subepithelial lymphoid tissue and reactive changes. Conclusion: Branchial cyst should be considered in the differential diagnosis of a lateral cystic neck swelling in young patients. Complete surgical excision is both diagnostic and curative, and histopathology provides definitive confirmation while excluding more sinister mimics.