Case submitted by Dr Smita Deb and A/Prof Pramit Phal.

Initially a CT neck was done with the differential diagnoses being: branchial cleft cyst vs veno-lymphatic malformation.

However, given the variegated cystic appearance on MRI as well as the branching structures near the mass on CT (atypical for branchial cleft cyst), a venolymphatic malformation is favored over a complicated branchial cleft cyst.

USS + FNA was done which confirmed a branchial cleft cyst.