Infected 4th branchial cleft cyst

Case contributed by Dr Mostafa Mahmoud El-Feky


Clinically suspected left neck abscess.

Patient Data

Age: 25 years
Gender: Male

CT neck with contrast

An abscess is noted involving the upper pole of the left lobe of thyroid gland extending to ipsilateral carotid and retropharyngeal spaces. It is measuring about 2.5 x 4.5 cm in axial dimensions surrounded by deep space cellulitis. It is involving the left sternomastoid muscle with muscle enlargement and interstitial edema.

Case Discussion

The radiological features are suggestive of abscess at the left side of the neck near thyroid gland with the possibility of an infected fourth branchial cleft cyst and abscess formation. Fourth branchial cleft cyst is a rare branchial cleft cyst which occurs along the course of the recurrent laryngeal nerve. It is most commonly on the left side (80%) and commonly located adjacent to the thyroid gland. The most common presentation is abscess within or anterior to the left thyroid lobe.

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Case information

rID: 54796
Published: 11th Aug 2017
Last edited: 5th Sep 2017
System: Head & Neck
Inclusion in quiz mode: Included

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