Branchial cleft cyst

Case contributed by Dr Paul Smith
Ultrasound

A well circumscribed lesion of decreased echogenicity is identified 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 breach, the skin- a finding which resembles an aubergine and stalk.

No vascularity is noted, with posterior acoustic shadowing identified.

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

Case Discussion

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.

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