Infected second branchial cleft cyst

Case contributed by Dr Mohammad A. ElBeialy

Presentation

Lower cranial nerve palsy with diffulty in phonation & swallowing. Headache and mild pyrexia since 10 days.

Patient Data

Age: 50 years
Gender: Male
Modality: MRI
  • a right para-pharyngeal ovoid cystic lesion is seen, showing hyperintense T1 and hyperintense T2 signal with sedimentation level demonstrating T2 hypointensity of the basal layer. 
    • the lesion measures about 5 X 3 X 2.5 cm in its main CC and axial diameters respectively, and shows marginal post contrast enhancement. 
    • the lesion is seen compressing the right oropharyngeal wall and extending from the skull bone to the level of the right submandibular gland. 
    • the lesion is abutting the right medial pterygoid and the right paravertebral long coli muscles. 
  • no enlarged cervical lymph nodes. 
  • no other neck masses. 
  • normal larynx and laryngeal skeleton. 
  • normal great vessels of the neck. 

Conclusion:

Right para-pharyngeal marginally enhancing cystic lesion - infected 2nd branchial cleft cyst.

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Case Information

rID: 23437
Case created: 15th Jun 2013
Last edited: 25th Feb 2016
System: Head & Neck
Inclusion in quiz mode: Included

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