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Branchial cleft cyst

Case contributed by: Dr Paul Smith

From the case: Branchial cleft cyst

Modality: Ultrasound

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Branchial Cleft Cyst

Case Discussion:

A well circumscribed lesion of decreased echogenicity is identified in anterior to the right sternocleidomastoid muscle in the infrahyoid neck.

A small duct arises from the anterior apex of the lesion and courses to, but does not breech, the skin- a finding which resembles an aubergine and stalk.

No vascularity is noted, with posterior accoustic shadowing identified.

The appearance is stable in appearance and has not changed in appearance over multiple ultrasound scans.

Whilst initially attributed to a 4th branchial cleft cyst owing to its anteroinferior position sternocleidomastoid and close proximity to the thyroid, however given its more superficial nature a 2nd branchial cleft cyst may be more likely.