Second branchial cleft cyst

Branchial cleft cysts are the most common congenital  neckneck mass, they appear in early adulthood, usually as painless slow-growingneck swelling  asas in this patient.

ComplicationComplications include hemorrhagehaemorrhage and secondary infection.

 Right - sidedRight-sided neck cystic structure is seen as a sharply marginated,  ovoid ovoid with fine internal echoes, representing debris, it has a thin peripheral wall that displaces the surrounding soft tissues. The lesion shows acoustic enhancement. The cyst is closely related and displace the ICA and ECA, no internal vascularity, no soft tissue nodules or wall thickening.

At CT, the cyst is typically well-circumscribed, homogeneously hypoattenuatedhypoattenuating mass surrounded by a uniformly thin wall.  The location of the cyst is at the anteromedial border of the sternocleidomastoid muscle, lateral to the carotid space, and posterior to the submandibular gland. The cyst displaces the sternocleidomastoid muscle posteriorly ,theand the vessels of the carotid space medially and the submandibular gland anteriorly .   A.  A subtle curved rim of tissue or “beak” pointing medially between the internal and external carotid arteries, which is called a “beak sign”. It shows thin mild uniform wall enhancement. NO

No stranding of adjacent fatty plans, wall thickening or lymphadenopathy to suggest secondary infection.