Infected 2nd branchial cleft cyst
60 years old male presents with painful right neck lump
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There is a well-defined cystic lesion in the right side of the neck anterior to the right sternomastoid muscle indenting the inferior border of the parotid gland, compressing and stretching the internal jugular vein on its medial and anterior borders. It also results in anterior displacement of the right sub-mandibular gland.This lesion has a relatively thick enhancing wall and measures about 4 cm in its maximum diameter with no signs of invasion into surrounding structures. Enlarged right thyroid lobe also noted.
Right sided cystic neck lesion related to the sternomastoid muscle represents a 2nd branchial cleft cyst.