Second branchial cleft cyst

Case contributed by Mohamed Mahmoud Elthokapy


Painless right-sided fluctuant neck swelling for a long time.

Patient Data

Age: 30 years
Gender: Male

Right upper lateral neck aspect well defined ovoid slightly lobulated cystic lesion measuring about 32 x 22 x 44.5 mm in its maximum dimensions with anatomical relation as follows;

  • postero-lateral to the right submandibular gland
  • lateral to the right carotid sheath
  • anteromedial to the right sterno-cleido-mastoid muscle
  • extending superiorly into para-pharyngeal space

It elicits low signal intensity in T1 and intermediate to low T2 with no fat saturation in the T1FS sequence, suggesting high proteinaceous content and no significant enhancement in the post-contrast study, apart from mural enhancement.

Case Discussion

Imaging findings of a cystic neck lesion with the classic location for a second branchial cleft cyst

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