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Branchial cleft cyst or sinus in Adult
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Branchial cleft cyst or sinus in Adult

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Contributors: Craig N. Burkhart MD, Dean Morrell MD, Belinda Tan MD, PhD, Lowell A. Goldsmith MD, MPH
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Synopsis

Branchial cleft cyst or sinus : Anterior neck, Cyst, Smooth nodule, Neck mass
Branchial cleft cyst or sinus is a rare disorder resulting from incomplete closure of the branchial clefts. The second branchial cleft is implicated much more so than the third cleft. This typically occurs at 4-8 weeks of embryologic growth. Cysts, sinuses, or fistulae can present at birth at the inferior neck. At times these small cysts or skin tag-like remnants contain cartilage. Autosomal dominant inheritance has been reported.

Sometimes a branchial cleft cyst or sinus is not recognized until later in childhood, when it becomes infected. Rarely, it may go unnoticed until it becomes infected in adulthood. A laryngocele may present with a neck mass and is associated with hoarseness and swelling.

Codes

ICD10CM:
Q18.0 – Sinus, fistula and cyst of branchial cleft

SNOMEDCT:
59857007 – Branchial cleft cyst

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Thyroglossal duct cyst – Midline cystic lesion, often near the hyoid bone, often with a draining sinus.
  • Pilomatricoma (calcifying epithelioma of Malherbe)
  • A malignancy must be considered in a new-onset neck mass in an adult, especially when associated with enlarged lymph nodes.
  • Midline anterior neck inclusion cyst (MANIC) – A type of superficial midline developmental anomaly

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated:01/12/2022
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Branchial cleft cyst or sinus in Adult
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A medical illustration showing key findings of Branchial cleft cyst or sinus : Anterior neck, Cyst, Smooth nodule, Neck mass
Clinical image of Branchial cleft cyst or sinus - imageId=324828. Click to open in gallery. caption: 'A smooth, yellowish papule with surrounding erythema, on the lateral neck.'
A smooth, yellowish papule with surrounding erythema, on the lateral neck.

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