Presentation
Long-standing painless neck mass (present several decades).
Patient Data
A well-circumscribed, oval-shaped cystic lesion was seen at the anteromedial aspect of the right sternocleidomastoid muscle, posterior to the submandibular gland, and lateral to the carotid sheath. It extends from above the angle of the mandible to the lower border of the thyroid cartilage
It displaces rather than infiltrates nearby structures, pushing the right submandibular gland anteromedially, stretching the right internal jugular vein at its posteromedial and the common facial vein at its medial edge, almost effacing their lumens (no thrombosis/invasion).
Size-related mass effect gently displaces the oropharynx and laryngeal cartilages to the left of the midline, but there is no airway compromise or laryngeal deformity.
It is thin-walled with an average density of 15-25 HU, no internal solid/enhancing component, no calcification, no feature of superadded infection or rupture, and no sinus to the skin or deep fistulous tract.
Case Discussion
The historical and imaging features were most compatible with a right-sided 2nd branchial cleft cyst, Bailey classification type II.
Unable to process the form. Check for errors and try again.