186 results on '"Branchioma diagnostic imaging"'
Search Results
2. The utility of ultrasonographic surveillance in management of a presumed branchial cleft cyst later confirmed HPV-associated oropharyngeal cancer.
- Author
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Ferraro T, Pershad AR, Arora S, Lee E, and Joshi A
- Subjects
- Humans, Male, Middle Aged, Positron Emission Tomography Computed Tomography, Squamous Cell Carcinoma of Head and Neck diagnostic imaging, Branchioma diagnostic imaging, Branchioma surgery, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell surgery, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms surgery, Oropharyngeal Neoplasms, Papillomavirus Infections complications
- Abstract
While branchial cleft cysts are often considered benign pathologies, the literature discusses cases of squamous cell carcinoma (SCC) arising from these cystic lesions as either a primary or metastatic tumor. We illustrate our institutional experience and review the current literature to identify recommendations for best diagnostic, surveillance, and treatment guidelines for SCC identified in a branchial cleft cyst. A 61-year-old male presented with a right sided neck mass, with suspicion of a branchial cleft cyst due to benign findings on fine needle aspiration. Following surgical excision, a focus of SCC was found on surgical pathology. Despite PET/CT and flexible laryngoscopy, no primary tumor was identified prompting routine surveillance every 3 months with cervical ultrasonography and flexible nasolaryngoscopy. Two and a half years following his initial presentation, pathologic right level II lymphadenopathy was detected on ultrasound without evidence of primary tumor. Subsequent transoral robotic surgery with right tonsillectomy and partial pharyngectomy, with right lateral neck dissection revealed a diagnosis of pT1N1 HPV-HNSCC and he was referred for adjuvant chemotherapy and radiation. To our knowledge there are less than 10 cases of confirmed HPV-associated oropharyngeal SCC arising from a branchial cleft cyst. Here we demonstrate the utility of ultrasound as a surveillance tool and emphasize a higher index of suspicion for carcinoma in adult patients with cystic neck masses., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)
- Published
- 2024
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3. Ultrasound diagnosis and treatment of branchial cleft cyst and preoperative management.
- Author
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Wang FJ, Xu F, Xiao LH, Qin F, Zhang LH, Wang L, Qi XQ, and Weng CY
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- Male, Female, Humans, Animals, Rats, Adult, Retrospective Studies, Branchial Region diagnostic imaging, Branchial Region surgery, Branchial Region abnormalities, Ultrasonography, Branchioma diagnostic imaging, Branchioma surgery, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms surgery, Fistula surgery
- Abstract
Objective: The ultrasonic diagnosis of cervical and facial cystic masses, as well as cases of missed diagnosis and misdiagnosis, was examined, to improve the diagnosis of branchial cleft anomalies., Methods: A retrospective analysis was conducted on 17 patients with branchial cleft cyst anomalies, including 11 males and 6 females, aged 12-53 years, with an average age of 33 ± 2 years, were unilateral single. All patients who underwent an ultrasound examination and image storage for retrospective analysis, and both longitudinal and transverse sections were scanned to observe the shape, size, boundary, peripheral relationship, and blood flow signal of the masses. All cases were examined with an enhanced CT scan, and pathological reports were generated., Results: Among the 17 cases of branchial cleft anomalies, 15 cases were branchial cleft cysts, while one case involved fistula formation and one case involved sinus tract formation. Based on the type of branchial cleft, the first, second, and third cysts were classified in 4, 12, and 1 case, respectively. The sensitivity rate and specificity of ultrasonic diagnosis were 14/17 (82.4%) and 4/6 (66.7%), respectively. Ultrasonic characteristic analysis for the masses can be found in simple cystic masses or hypoechoic masses, most of them are of a regular shape and have a distinct boundary, and almost no blood flow signal. All patients who were misdiagnosed exhibited blood flow signals, including 1 patient with an abundant blood flow signal, 1 patient suspected of having ectopic thyroid with an abnormal function due to the rat-tail sign, 2 patients misdiagnosed as local inflammatory focus, and 1 patient misdiagnosed with tuberculous lymphadenitis., Conclusion: Ultrasound has a detection rate of up to 100% for cervical and facial masses, providing a fundamental determination of lesion characteristics and specific guidance for preoperative diagnosis. If the blood flow signals can be identified and carefully considered their peripheral relationship, the diagnostic rate can be improved., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
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- 2024
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4. Tracheal Deviation and Life-threatening Presentation of Congenital Branchial Cleft Cyst Abscess due to Rare Pathogens and Difficult Airway Management.
- Author
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Daşdemir S, Sanar AY, Yazici MU, Gudeloglu E, Akkuzu E, Düzlü M, and Tezer H
- Subjects
- Humans, Abscess diagnostic imaging, Abscess surgery, Diagnosis, Differential, Branchioma diagnostic imaging, Branchioma surgery
- Abstract
Competing Interests: Disclosure The authors report no conflicts of interest in this work.
- Published
- 2023
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5. Branchiogenic cyst ‒ a rare finding in vascular surgery.
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Zavacka M, Pobehova J, and Zavacky P
- Subjects
- Humans, Vascular Surgical Procedures, Branchial Region pathology, Tomography, X-Ray Computed, Branchioma diagnostic imaging, Branchioma surgery, Branchioma pathology, Head and Neck Neoplasms
- Abstract
Branchiogenic cysts are benign lesions caused by anomalous development of the branchial cleft. They are typically detected in individuals aged between their twenties and forties. Ultrasonography is the first-line imaging method of choice. Surgical excision is the sole treatment modality (Tab. 1, Fig. 6, Ref. 25). Keywords: branchiogenic cyst, extirpation, ultrasonography, computed tomography.
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- 2023
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6. Second Branchial Cleft Cyst.
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Iio K and Yoshitomi A
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- Branchial Region diagnostic imaging, Diagnosis, Differential, Humans, Branchioma diagnostic imaging, Head and Neck Neoplasms diagnostic imaging
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- 2022
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7. Computed Tomography Findings of Complete Branchial Cleft Fistula.
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King J and Mitchell B
- Subjects
- Adult, Branchial Region abnormalities, Branchial Region diagnostic imaging, Branchial Region surgery, Craniofacial Abnormalities, Female, Humans, Pharyngeal Diseases, Tomography, X-Ray Computed, Young Adult, Branchioma congenital, Branchioma diagnostic imaging, Branchioma surgery, Fistula diagnostic imaging, Fistula surgery, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms surgery
- Abstract
Branchial cleft anomalies are embryonic remnants of the branchial arches and are described as the second most common congenital neck mass. Depending on their extent, these anomalies are classified as a cyst, sinus, or fistula with branchial cysts being the most common. Branchial cysts deriving from the second branchial arch are by far the most common, accounting for approximately 95% of all cases. Complete second branch arch fistulas with both an internal and external opening are a rare variant of this anomaly, and even less have been well-documented on computed tomography (CT) imaging in the literature. We present here a case of a 20-year-old female with CT findings consistent with a complete second branchial arch fistula extending from the tonsillar fossa to the external lateral neck.
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- 2022
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8. Branchial cleft cyst-like anomaly of the external auditory canal in a dog.
- Author
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Arcuri L, Ricciardi M, Grieco G, Pollina G, Mandetta F, and Zammit R
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- Animals, Branchioma diagnostic imaging, Branchioma surgery, Dogs, Branchioma veterinary, Dog Diseases diagnostic imaging, Dog Diseases surgery, Ear Canal abnormalities, Ear Canal diagnostic imaging
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- 2021
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9. Pre and postnatal diagnosis of a third branchial cleft cyst by sonography and magnetic resonance imaging with three-dimensional virtual reconstruction.
- Author
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Castro PT, Werner H, Fazecas T, Matos AP, Maia F, de Mello PP, and Araujo Júnior E
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- Adult, Child, Female, Humans, Infant, Newborn, Magnetic Resonance Imaging, Pregnancy, Prenatal Diagnosis, Ultrasonography, Branchioma diagnostic imaging, Head and Neck Neoplasms diagnostic imaging
- Abstract
Branchial cleft cysts (BCCs) are common causes of cervical tumors in children and adulthood; however, prenatal diagnosis of BCC is rare. In neonates, these cysts can suddenly increase in size, causing airway obstruction and becoming a life-threatening condition. In this case report, we describe the prenatal diagnosis of a third BCC at the 25th week of pregnancy using ultrasound, magnetic resonance imaging, and three-dimensional virtual models, as well as the perinatal outcomes of this rare condition., (© 2021 Wiley Periodicals LLC.)
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- 2021
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10. Prenatal Diagnosis of Third and Fourth Branchial Apparatus Anomalies: Case Series and Comparison with Lymphatic Malformation.
- Author
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Li Y, Mashhood A, Mamlouk MD, Lindan CE, Feldstein VA, and Glenn OA
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- Branchial Region diagnostic imaging, Female, Humans, Pregnancy, Prenatal Diagnosis, Retrospective Studies, Branchioma diagnostic imaging, Head and Neck Neoplasms
- Abstract
Background and Purpose: Third and fourth branchial apparatus anomalies are rare congenital anomalies. The purpose of this study was to investigate imaging features of these lesions on fetal MR imaging in comparison with lymphatic malformations, the major competing differential diagnosis in these cases., Materials and Methods: A retrospective review of our institutional fetal MR imaging database between 1997 and 2019 resulted in 4 patients with confirmed third and fourth branchial apparatus anomalies and 14 patients with confirmed lymphatic malformations. The imaging features were reviewed by consensus, and the Fisher exact test was used to evaluate statistically significant differences between these 2 populations., Results: Four cases of third and fourth branchial apparatus anomalies were imaged at 29 weeks 1 day (range, 23 weeks 1 day to 33 weeks 4 days). All 4 cases demonstrated unilateral, unilocular cysts without reduced diffusion or hemorrhage and a medially directed beaked contour that tapered between the spine and airway at the level of the piriform sinus. Compared with 14 cases of fetal lymphatic malformations imaged at 27 weeks 6 days (range, 21 weeks 3 days to 34 weeks 6 days), third and fourth branchial apparatus cysts were significantly more likely to be unilocular ( P < .005) and to have a medially beaked contour ( P < .005). The combination of features of unilateral, unilocular, and medially beaked contour was observed only in the fetuses with third and fourth branchial apparatus cysts ( P < .001)., Conclusions: The presence of a left-sided unilocular cyst with a medially beaked contour tapering at the level of the piriform sinus suggests the diagnosis of third and fourth branchial apparatus anomaly. Accurate diagnosis in the prenatal period allows proper counseling, genetic work-up, and treatment, potentially sparing patients from recurrent infections and associated morbidity., (© 2021 by American Journal of Neuroradiology.)
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- 2021
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11. Excision of rare adult cervical thymic cyst.
- Author
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Cromar ZJ, Shah VN, Kamrava B, Nissim KR, and Velez-Torres JM
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- Adult, Diagnosis, Differential, Humans, Magnetic Resonance Imaging, Male, Neck diagnostic imaging, Neck surgery, Young Adult, Branchioma diagnostic imaging, Branchioma surgery, Mediastinal Cyst diagnostic imaging, Mediastinal Cyst surgery
- Abstract
Cervical thymic cysts (CTCs) represent 1% of all cervical cystic masses. A review of the literature found that CTCs are typically asymptomatic, with a propensity to be left sided. CTCs often require histological evaluation for diagnosis. A 27-year-old male patient presented to an outpatient otolaryngology clinic with worsening bilateral jaw and neck pain and an incidental right-sided neck mass found on cervical MRI. Preoperative differential diagnosis included venolymphatic malformation versus branchial cleft cyst. Histological examination of the excised specimen provided diagnosis of a CTC. Postoperatively, the patient reported improvement in cervical pain. CTCs are a rare cause of lateral neck mass in young adults. Typical presentation included neck enlargement with no symptoms or in some cases compressive symptoms. It is important to consider CTCs when formulating a differential for a lateral neck mass., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2021
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12. First branchial cleft anomaly extending to parapharyngeal space.
- Author
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Devaraja K, Godkhindi VM, and Bhandarkar AM
- Subjects
- Adult, Branchial Region diagnostic imaging, Branchial Region surgery, Ear Canal diagnostic imaging, Ear Canal surgery, Humans, Parapharyngeal Space, Young Adult, Branchioma diagnostic imaging, Branchioma surgery, Head and Neck Neoplasms
- Abstract
First branchial cleft anomalies are quite rare, and the majority of them are found in and around the ear canal, mostly superficial to the facial nerve. Very rarely, the anomalous tract of the first branchial cleft can go deeper to the facial nerve, necessitating a meticulous and extensive surgery. A 21-year-old student presented with slowly increasing cystic swelling in the infra-auricular region. Findings of the magnetic resonance imaging were consistent with the first branchial cleft cyst, which also exhibited a deeper extent of the lesion into the parapharyngeal space. The entire tract was excised along with the superficial parotidectomy by an open approach. In addition to illustrating the presentation and management of this peculiar case, the present report also reviews the latest literature around their management., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2021. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2021
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13. Third branchial cleft cyst as a cause of hoarseness: a case report.
- Author
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Li Z, Zhang J, Yang Y, and He X
- Subjects
- Adult, Female, Hoarseness diagnostic imaging, Hoarseness etiology, Humans, Recurrent Laryngeal Nerve diagnostic imaging, Branchioma complications, Branchioma diagnostic imaging, Branchioma surgery, Head and Neck Neoplasms, Vocal Cord Paralysis diagnostic imaging, Vocal Cord Paralysis etiology
- Abstract
Third branchial cleft cyst is a rare congenital disease of the neck. It presents as a painless mass that develops rapidly in the neck following an infection. This is the first case report of recurrent laryngeal nerve palsy caused by a third branchial cleft cyst. A 30-year-old woman presented with a 3-month history of hoarseness as her only symptom; she had no pain, fever, dysphagia, dyspnoea, or palpable neck mass. Laryngoscopy revealed that her right vocal cord was paralyzed. Computed tomography and magnetic resonance imaging revealed a cystic mass in the right tracheoesophageal groove that was closely associated with the trachea. Intraoperatively, the cyst was found not to originate from the thyroid or trachea, but it was compressing the right recurrent laryngeal nerve. The hoarseness resolved the day after the cyst was removed.
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- 2021
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14. Unusual location of a second branchial cleft cyst presenting in the suprasternal notch.
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Xing MH, Mundi N, Govindan A, Khorsandi A, and Urken ML
- Subjects
- Adolescent, Branchial Region diagnostic imaging, Branchial Region surgery, Diagnosis, Differential, Humans, Male, Neck surgery, Branchioma diagnostic imaging, Branchioma surgery, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms surgery, Pharyngeal Diseases
- Abstract
Background: Second branchial cleft cysts (SBCCs) are congenital benign tumors that comprise up to 90% of all branchial cleft anomalies. SBCCs typically present in the lateral neck along the anterior border of the upper third of the sternocleidomastoid muscle. We describe a case of a SBCC presenting in an unusual location in the lower neck close to midline., Methods: An 18-year-old male presented with a 2-year history of a neck mass in the suprasternal notch. Imaging findings were reviewed with a head and neck radiologist who felt that the findings were highly suggestive of a fourth branchial cleft cyst., Results: The patient underwent surgical excision of the mass. Final pathologic evaluation confirmed the diagnosis of a second branchial cleft cyst., Conclusions: Though extremely uncommon, second branchial cleft cysts can extend to the suprasternal notch and should not be excluded from the differential diagnoses of lower neck masses., (© 2021 Wiley Periodicals LLC.)
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- 2021
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15. Facial swelling for the emergency radiologist-typical and atypical causes.
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Smith SM, Thelen JC, Bhatt AA, and Kessler AT
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- Branchioma diagnostic imaging, Diagnosis, Differential, Eye Diseases diagnostic imaging, Humans, Intracranial Thrombosis diagnostic imaging, Paranasal Sinus Diseases diagnostic imaging, Ranula diagnostic imaging, Rhabdomyolysis diagnostic imaging, Stomatognathic Diseases diagnostic imaging, Edema diagnostic imaging, Emergencies, Face, Magnetic Resonance Imaging, Tomography, X-Ray Computed
- Abstract
There are a wide variety of inflammatory, infectious, and cystic lesions which may lead patients to seek acute care for facial swelling. Computed tomography (CT) has become the mainstay for imaging in the urgent/emergent setting. However, magnetic resonance imaging (MRI) can also serve as a powerful problem solving tool in the modern era. As volume continues to increase, a wide variety of facial pathology will be encountered by the emergency radiologist. Recognition of both common and uncommon pathology will assist in diagnosis and value-based care. This article serves as an image-rich review of the many causes of facial swelling with an emphasis on key imaging findings and possible complications.
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- 2021
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16. Management of a prestyloid parapharyngeal first branchial cleft cyst from puncture to surgical excision and how a routine procedure can turn into an emergency.
- Author
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Fiedler LS
- Subjects
- Aged, Branchioma diagnostic imaging, Female, Humans, Magnetic Resonance Imaging, Retrospective Studies, Tomography, X-Ray Computed, Tracheostomy methods, Branchioma surgery, Punctures adverse effects
- Abstract
The anatomy of the parapharyngeal space (PPS) is complex and the differential diagnosis of tumours in this area broad. Although primary tumours of the PPS account for only 0.5% of head and neck neoplasms and are benign lesions in 80% of the cases, the surgical management is crucial and needs specific planning and evaluation of CT and/or MRI scans. In literature, there are several ways to surgically deal with PPS tumours and due to location and differentiation, can reach from transparotid, submandibular transcervical and transoral approaches, extending in a mandibulotomy, further radiotherapy. Parapharyngeal cleft cysts are extremely rare and their management can be complex. We describe the presentation, the diagnosis and further management of a 71-year-old woman with a 6 cm first branchial cleft cyst in the PPS from puncture over emergency tracheostomy to elective excision via a combined transcervical/transparotid and transoral approach. We highlight the importance of the differential diagnosis and the and the correct clinical management of this rare entity., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2021
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17. Endoscopy for a fourth branchial cleft cyst.
- Author
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Saadoun A
- Subjects
- Branchioma complications, Branchioma pathology, Cellulitis etiology, Child, Electrocoagulation methods, Endoscopy methods, Female, Humans, Neck, Branchioma diagnostic imaging, Branchioma surgery, Rare Diseases
- Published
- 2020
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18. Unusual presentation of a first Branchial cleft cyst associated with an abnormal bony canal -a case report.
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Fanous A, Couloigner V, Gorphe P, Galmiche L, Alexandru M, Garabedian EN, Coffinet L, Blanc T, Leboulanger N, and Denoyelle F
- Subjects
- Branchioma diagnostic imaging, Branchioma surgery, Child, Cholesteatoma, Middle Ear surgery, Cysts surgery, Facial Nerve, Hearing Loss, Conductive etiology, Humans, Magnetic Resonance Imaging, Male, Parapharyngeal Space, Pharyngeal Diseases surgery, Pharynx surgery, Robotic Surgical Procedures, Tomography, X-Ray Computed, Branchioma complications, Cysts complications, Ear Canal abnormalities, Pharyngeal Diseases complications
- Abstract
Background: First branchial cleft anomalies are rare, accounting for only 10% of all branchial cleft anomalies. We report an even more rare and unique case of a branchial cleft cyst with features of both first and second arch derivatives., Case Presentation: A 6-year-old boy presented to us with a left conductive hearing loss associated with pre-tympanic keratin debris and an ipsilateral painful cervical mass. He had a past medical history of left ear surgery for presumed cholesteatoma 2 years prior and left neck abscess drainage 6 months prior. CT and MRI revealed a lesion originating in the external auditory canal and extending cervically through a bony canal located medial to the facial nerve and terminating as a parapharyngeal cyst. The complete removal was accomplished in one surgical stage consisting of three distinct steps: robotic assisted transoral resection of the pharyngeal cyst, an endaural approach and a parotidectomy approach., Conclusion: We believe that our detailed description of this rare first branchial cleft cyst with pharyngeal extension, possibly a hybrid case between a first and second branchial cyst, can serve as a valuable tool to Otolaryngologists - Head and Neck Surgeons who come across a similar unusual presentations.
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- 2020
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19. Congenital Incidental Findings in Children that Can Be Mistaken as True Pathologies in Adults: Pearls and Pittfalls of Imaging Diagnosis.
- Author
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Schooler GR, Restrepo R, Mas RP, and Lee EY
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- Adult, Child, Humans, Branchioma diagnostic imaging, Diagnostic Imaging methods, Incidental Findings, Kidney abnormalities, Musculoskeletal Abnormalities diagnostic imaging, Respiratory System Abnormalities diagnostic imaging, Thymus Gland abnormalities, Thymus Gland diagnostic imaging
- Abstract
Congenital entities sharing imaging characteristics with true pathologies occasionally are discovered incidentally in adults. These may occur in the neck, chest, abdomen/pelvis, or musculoskeletal systems. Although these incidental findings share imaging features with true pathologic processes, up-to-date knowledge and assessment with the most appropriate imaging modalities generally allow a distinction between congenital entities that may be safely dismissed and pathologic processes requiring further assessment and treatment. This article reviews several of the most common congenital processes that may present incidentally in adult patients mimicking disease. Emphasis is on findings that can be used to distinguish congenital process from true disease processes., (Copyright © 2020 Elsevier Inc. All rights reserved.)
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- 2020
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20. [Application of multi-slice spiral CT in the diagnosis of children's parotid cleft deformity].
- Author
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Liu J and Yang X
- Subjects
- Child, Humans, Parotid Gland diagnostic imaging, Retrospective Studies, Branchioma diagnostic imaging, Head and Neck Neoplasms diagnostic imaging, Parotid Gland pathology, Tomography, Spiral Computed
- Abstract
Objective: The aim of this study is to evaluate the value of multi-slice spiral CT (CT) and multi-planar reconstruction (MPR) in the diagnosis of children with parotid cleft deformity. Method: The CT images of 55 cases of branchial cleft deformity confirmed by surgery and pathology were retrospectively analyzed. Result: CT examination showed that 37 cases had strip-like, tubular fistula or cystic mass located in the anterior cervical triangle, anterior margin of sternocleidomastoid muscle, and 2 of them had bilateral fistula structure. In 16 casescystic mass and tubular fistula were found in the parotid gland or at the edge of the parotid gland. One case was accompanied by atresia of the lateral auditory meatus. After contrast enhancement, the cystic wall(tube wall) of 55 patients were enhanced. In 9 patients with infection, the boundary of the lesion was blurred, and the density of the cyst or lumen increased after contrast enhancement. MSCT diagnosed 6 cases of parotid cleft cyst with fistula, 35 cases of branchial cleft cyst, 13 cases of parotid fistula, and 1 case misdiagnosed as lymphadenitis. Among all the cases, 15 were type Ⅰ, 36 were type Ⅱand 4 were type Ⅲ. Compared with the results of pathological diagnosis and clinical operation, the accuracy of qualitative diagnosis and localization was 99.9% and 100.0%. Conclusion: Multi-slice spiral CT thin-slice images combined with MPR image post-processing technology can better display the location of branchial cyst and the course of branchial fistula., Competing Interests: The authors of this article and the planning committee members and staff have no relevant financial relationships with commercial interests to disclose., (Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.)
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- 2020
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21. Facial Nerve Duplication and First Branchial Cleft Cysts: An Association in an Uncommon Pathology.
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Eide J, Isaac A, and Maddalozzo J
- Subjects
- Adolescent, Branchioma diagnostic imaging, Head and Neck Neoplasms diagnostic imaging, Humans, Magnetic Resonance Imaging, Male, Branchioma complications, Facial Nerve abnormalities, Head and Neck Neoplasms complications
- Published
- 2019
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22. Unusual Presentation of a Large Multilocular Second Branchial Cleft Cyst.
- Author
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Al Sukhun J and El Naggar M
- Subjects
- Branchioma diagnostic imaging, Child, Female, Head and Neck Neoplasms diagnostic imaging, Humans, Branchioma surgery, Head and Neck Neoplasms surgery
- Abstract
Second branchial cleft cysts (BCCs) are the most common type of branchial abnormalities and usually found high in the neck. Oropharyngeal presence of a BCC is very rare. The authors report a rare case of oropharyngeal, second branchial, multilocular, cleft cyst in a 9-year-old child (8.0 × 5.0 cm in maximum diameter). The cyst was removed completely via extra/intraoral approach and did not have tract-like structure. The anatomic location together with the histopathology results, which showed a squamous epithelium-lined cystic wall with lymphoid aggregation, were characteristic findings of a BCC. Patient was discharged without any complication, and a regular follow-up of 6 months showed no evidence of recurrency. Having reviewed the literature, it seems to be that this is the first case to be reported of a multilocular BCC, excised of this size, from the oropharyngeal area in a child. Other pathological lumps of the neck have similar presentation with BCC, which makes it difficult, sometimes, to reach an accurate diagnosis. Clinicians should be aware of this pathology because it can be easily misdiagnosed as an odontogenic cyst and/or salivary gland infection, especially if it develops high up in the neck.
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- 2019
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23. CT and MR imaging findings of infection-free and benign second branchial cleft cysts.
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Kawaguchi M, Kato H, Aoki M, Kuze B, Hara A, and Matsuo M
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- Adolescent, Adult, Female, Humans, Male, Middle Aged, Retrospective Studies, Young Adult, Branchioma diagnostic imaging, Magnetic Resonance Imaging, Tomography, X-Ray Computed
- Abstract
Purpose: The present study aimed to assess CT and MR imaging findings of infection-free and benign second branchial cleft cysts (SBCCs)., Methods: Eleven patients with histopathologically confirmed infection-free and benign SBCCs underwent preoperative contrast-enhanced CT (CECT) and/or MR imaging. We assessed qualitative (presence and extent of wall thickening, degree of contrast enhancement of the thickened wall on CECT images, and signal intensity of the thickened wall on T2-weighted images) and quantitative (maximum thickness of the thickened wall) imaging findings., Results: Eccentric and smooth wall thickening was observed in 11/11 (100%) patients. The wall thickening extent (percentage of the thickened wall to the circumference of the wall) was small (1%-25%) in 4/11 (36%), moderate (26%-50%) in 6/11 (54%), extensive (51%-75%) in 1/11 (9%), and diffuse (76%-100%) in 0/11 (0%) patients. Mild homogeneous enhancement of the thickened wall on CECT images was observed in 7/7 (100%) patients. The signal intensity of the thickened wall on T2-weighted images was isointense relative to that of normal lymph nodes in 7/8 (88%) and mildly hyperintense in 1/8 (12%) patient. The maximum thickness of the thickened walls ranged from 2 to 4 (mean 3.4) mm., Conclusions: Infection-free and benign SBCCs are identifiable as cysts with eccentric and smooth wall thickening on CECT and MR images. The wall thickness was almost always less than half of the wall circumference, isointense relative to normal lymph nodes, and showed mild homogeneous enhancement.
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- 2019
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24. [Congenital cysts and fistulas on the neck in adults].
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Ballivet de Régloix S, Maurin O, Crambert A, Genestier L, Bonfort G, and Pons Y
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- Adult, Anti-Bacterial Agents therapeutic use, Branchioma diagnostic imaging, Branchioma drug therapy, Branchioma surgery, Combined Modality Therapy, Cutaneous Fistula diagnostic imaging, Cutaneous Fistula drug therapy, Cutaneous Fistula surgery, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms drug therapy, Head and Neck Neoplasms surgery, Humans, Inflammation, Thyroglossal Cyst diagnostic imaging, Thyroglossal Cyst drug therapy, Thyroglossal Cyst surgery, Branchioma congenital, Cutaneous Fistula congenital, Head and Neck Neoplasms congenital, Thyroglossal Cyst congenital
- Abstract
Cervical congenital malformations are relatively common in children. They can also be found in adults. The embryological development of the cervical region is closely related to the branchial clefts. This must be a diagnosis made by elimination; a cervical tumor must evoke the diagnosis of cancer. A cutaneous fistula or a cervical tumor, chronic or recent appearance in an inflammatory context, are the clinical signs. The thyroglossal duct cysts and the second branchial clefts cysts are the most common causes of median and lateral cervical cysts, respectively. Imaging contributes greatly to the orientation and diagnostic evaluation of the extent of the lesions. Treatment is initially based on antibiotic therapy and then on complete surgical excision, away from an infectious episode, the sole guarantee for the absence of local recurrence., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)
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- 2019
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25. Sonographic diagnosis of coexisting ectopic thyroid and fourth branchial cleft cyst.
- Author
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Oh JH, Chang YW, and Lee EJ
- Subjects
- Branchial Region diagnostic imaging, Diagnosis, Differential, Female, Humans, Infant, Ultrasonography methods, Branchioma complications, Branchioma diagnostic imaging, Head and Neck Neoplasms complications, Head and Neck Neoplasms diagnostic imaging, Thyroid Dysgenesis complications, Thyroid Dysgenesis diagnostic imaging
- Abstract
Ectopic thyroid and fourth branchial cleft anomaly are rare congenital anomalies of the neck. This is a case report of the coexistence of these two rare congenital anomalies in a 1-year-old girl. She had ectopic lingual thyroid and asymptomatic abscess in the fourth branchial cleft cyst, which was found in ultrasonography carried out to evaluate congenital hypothyroidism. To the best of our knowledge, this is the first reported case of ectopic thyroid coexisting with fourth branchial cleft anomaly in the same patient., (© 2018 Wiley Periodicals, Inc.)
- Published
- 2018
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26. A tale of two anomalies: fourth branchial cleft cyst with thyroid hemiagenesis.
- Author
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Ng TT, Soon DSC, and Mahanta V
- Subjects
- Adult, Aftercare, Biopsy, Fine-Needle methods, Branchial Region embryology, Branchioma diagnostic imaging, Humans, Magnetic Resonance Imaging, Male, Neck diagnostic imaging, Neck pathology, Shoulder Pain etiology, Thyroid Dysgenesis classification, Thyroid Dysgenesis pathology, Thyroid Gland diagnostic imaging, Thyroid Gland embryology, Tomography, X-Ray Computed, Treatment Outcome, Ultrasonography, Branchial Region abnormalities, Branchial Region pathology, Branchioma pathology, Thyroid Gland abnormalities, Thyroid Gland pathology
- Published
- 2018
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27. Branchial cleft cyst: An unusual site for the cervical metastasis of nasopharyngeal carcinoma.
- Author
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Liao YC, Adel M, Lee LY, and Chang KP
- Subjects
- Adult, Branchioma diagnostic imaging, Branchioma metabolism, Carcinoma diagnostic imaging, Carcinoma metabolism, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms metabolism, Head and Neck Neoplasms secondary, Herpesvirus 4, Human genetics, Humans, Male, Nasopharyngeal Carcinoma, Nasopharyngeal Neoplasms diagnostic imaging, Nasopharyngeal Neoplasms metabolism, Neoplasm Metastasis, RNA, Viral metabolism, Tomography, X-Ray Computed, Viral Matrix Proteins metabolism, Branchioma secondary, Carcinoma secondary, Nasopharyngeal Neoplasms secondary
- Abstract
Objective: Cancers found in the resected branchial cleft cyst are rare clinically but usually impose substantive diagnostic and treatment challenges for clinicians., Methods: A 31-year-old man presented with a lateral neck mass that was suspected to be an inflammatory branchial cleft cyst. After excision, the pathologic specimen revealed a benign cystic appearance with a focus of undifferentiated carcinoma. Serologic tests for Epstein-Barr virus were negative. A positron emission tomography scan and upper aerodigestive tract endoscopies were negative for any other suspicious lesion., Results: The patient underwent random biopsies of the nasopharynx, tongue base, and hypopharynx and bil tonsillectomy. Pathologic examination of the nasopharyngeal biopsies showed the presence of undifferentiated carcinoma. The cancerous part of the branchial cleft cyst and this nasopharyngeal specimen were positive for the latent membrane protein-1 and EBV-encoded RNAs of Epstein-Barr virus (EBV) and confirmed our diagnosis., Conclusion: This is the first report of a NPC metastasizing to a branchial cleft cyst. Molecular diagnostic techniques facilitate the definite diagnosis that enabled us to refine treatment plans and offered the patient a favorable outcome., (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
28. An Effective Surgical Approach for the Management of Recurrent First Branchial Cleft Fistula with Cysts: A Case Report.
- Author
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Jang M and Dai C
- Subjects
- Adult, Branchioma diagnostic imaging, Facial Nerve, Female, Humans, Neoplasm Recurrence, Local, Treatment Outcome, Branchial Region surgery, Branchioma surgery, Fistula surgery, Head and Neck Neoplasms surgery
- Abstract
The goal of this case report is to describe an unusual case of recurrent first branchial cleft fistula with cysts and the effective surgical approach of complete removal with preservation of the facial nerve. A 27-year-old woman presented to our clinic after unsuccessful removal twice during the last 20 years. We have achieved satisfactory outcomes by using an approach to identify the facial nerve at the stylomastoid foramen with canal wall up mastoidectomy under a microscope. No sign of facial palsy, hearing loss, or recurrence were noted in postoperative follow-up. This approach might facilitate the complete dissection of scar and lesions of recurrent first branchial cleft anomalies around the main trunk of the facial nerve in the parotid gland.
- Published
- 2017
- Full Text
- View/download PDF
29. Possible Estrogen Dependency in the Pathogenesis of Branchial Cleft Cysts.
- Author
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Raguse JD, Anagnostopoulos I, Doll C, Heiland M, and Jöhrens K
- Subjects
- Adult, Branchioma diagnostic imaging, Branchioma pathology, Female, Humans, Male, Pregnancy, Branchioma etiology, Estrogens metabolism
- Abstract
Background: Even though branchial cleft cysts are currently accepted as a congenital anomaly, there is often a long delay until clinical presentation; branchial cleft cysts classically appear in the second to fourth decade of life. Our observation of their occurrence in three pregnant women encouraged us to contemplate a possible hormonal influence., Methods: Immunohistological analysis was performed for the evaluation of the estrogen receptor alpha (ER α ) in paraffin-embedded tissue specimens of 16 patients with a diagnosis of branchial cleft cyst, with three of them being pregnant., Results: Expression of ER α was detected within epithelial cells only in branchial cleft cysts in pregnant females; moreover, higher growth fractions (Ki-67/Mib1) were found., Conclusion: The fact that the estrogen receptor was expressed only in pregnant women, in contrast to 13 investigated cases, may suggest that the high level of estrogen in pregnancy is a possible explanation for the spontaneous growth of branchial cleft cysts.
- Published
- 2017
- Full Text
- View/download PDF
30. First Branchial Cleft Cyst.
- Author
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Fastenberg J and Nassar M
- Subjects
- Branchioma pathology, Child, Preschool, Head and Neck Neoplasms pathology, Humans, Male, Tomography, X-Ray Computed, Branchial Region abnormalities, Branchioma diagnostic imaging, Craniofacial Abnormalities diagnosis, Head and Neck Neoplasms diagnostic imaging, Pharyngeal Diseases diagnosis
- Published
- 2016
- Full Text
- View/download PDF
31. The rare fourth branchial cleft anomaly.
- Author
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Harounian JA, Goldenberg D, and May JG
- Subjects
- Branchial Region diagnostic imaging, Branchial Region surgery, Branchioma surgery, Child, Craniofacial Abnormalities surgery, Female, Fistula surgery, Head and Neck Neoplasms surgery, Humans, Pharyngeal Diseases surgery, Tomography, X-Ray Computed, Branchial Region abnormalities, Branchioma diagnostic imaging, Craniofacial Abnormalities diagnostic imaging, Fistula diagnostic imaging, Head and Neck Neoplasms diagnostic imaging, Pharyngeal Diseases diagnostic imaging, Pyriform Sinus diagnostic imaging
- Published
- 2016
32. Pediatric Branchial Cleft Cysts: A Case Study.
- Author
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Sloand ED, Boeckner L, and DeSell MN
- Subjects
- Branchioma diagnostic imaging, Branchioma drug therapy, Child, Preschool, Diagnosis, Differential, Female, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms drug therapy, Humans, Magnetic Resonance Imaging, Neck Pain etiology, Thyroglossal Cyst diagnostic imaging, Thyroglossal Cyst drug therapy, Tomography, X-Ray Computed, Treatment Outcome, Anti-Bacterial Agents therapeutic use, Branchioma pathology, Clindamycin therapeutic use, Head and Neck Neoplasms pathology, Neck Pain diagnostic imaging, Thyroglossal Cyst pathology
- Published
- 2016
- Full Text
- View/download PDF
33. [Branchiogen cyst at unusual age and in rare localization. A case report].
- Author
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Horvath D, Redl P, and Hegedűs C
- Subjects
- Branchioma diagnostic imaging, Diagnosis, Differential, Female, Head and Neck Neoplasms diagnostic imaging, Humans, Infant, Magnetic Resonance Imaging, Male, Tomography, X-Ray Computed, Treatment Outcome, Branchioma diagnosis, Branchioma surgery, Head and Neck Neoplasms diagnosis, Head and Neck Neoplasms surgery, Nasopharynx diagnostic imaging, Nasopharynx pathology, Nasopharynx surgery
- Abstract
Branchiogen anomalies represent a heterogeneous group of developmental abnormalities, they arise from incomplete obliteration of branchial clefts and pouches during embriogenesis. Clinically they can present as a cyst, fistula or sinus. Second cleft lesions account for 95% of the branchial anomalies. Second branchial cleft cysts are usually located in the neck, along the anterior border of the stenocleidomastoid muscle, but they can be anywhere along the course of the second branchial fistula from the tonsillar fossa to the supraclavicular region. Their presence in the nasopharynx is extremely rare. Ultrasound, computed tomography (CT) or magnetic resonance imaging is recommended for diagnosis. Definitive treatment is surgical excision, these lesions do not regress spontaneously and often result recurrent infections. A 7 month old infant applied to a pediatrician with gastrointestinal viral infection. During examination a cystic mass was discovered in the right lateral nasopharyngeal wall, the lesion extended to the oropharynx. Marsupialisation was performed via transoral approach. In case of cystic lesion in the lateral epipharynx, branchial cleft cyst should be considered in the differential diagnosis.
- Published
- 2015
34. Branchial Cleft-Like Cysts Involving 3 Different Organs: Thyroid Gland, Thymus, and Parotid Gland.
- Author
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Nakazawa T, Kondo T, Oishi N, Tahara I, Kasai K, Inoue T, Mochizuki K, and Katoh R
- Subjects
- Adult, Branchioma diagnostic imaging, Head and Neck Neoplasms diagnostic imaging, Humans, Male, Neoplasms, Multiple Primary diagnostic imaging, Parotid Gland surgery, Parotid Neoplasms diagnostic imaging, Parotid Neoplasms pathology, Parotid Neoplasms surgery, Radiography, Thymus Neoplasms diagnostic imaging, Thymus Neoplasms pathology, Thyroid Neoplasms diagnostic imaging, Thyroid Neoplasms pathology, Thyroid Neoplasms surgery, Thyroidectomy methods, Branchioma pathology, Head and Neck Neoplasms pathology, Neoplasms, Multiple Primary pathology
- Abstract
Branchial cleft cysts (BCCs) are also named lateral cervical cysts and widely acknowledged as being derived from embryonic remnants. Lymphoepithelial cysts (LECs) generally show microscopic features that are identical to those of BCCs, and rarely occur at unusual sites or organs.A case of multiple cysts arising in both lobes of the thyroid gland, thymus, and right parotid gland in a 41-year-old man is reported. Clinically, the patient presented with Hashimoto's thyroiditis for about 20 years and had past histories of idiopathic thrombocytopenic purpura and severe respiratory infection.This case is unusual in that multiple cysts arose synchronously and/or heterochronously and grew, increasing their sizes in these different organs. Microscopic examinations revealed that all of the cysts were composed of squamous epithelium, dense lymphoid tissue with germinal centers, and a fibrous capsule. These findings corresponded to those of BCCs or LECs. It is notable that the histopathological features were nearly the same in the individual organs. A review of the literature disclosed no previous such reported cases.The etiology is unknown. However, based upon the similar histopathological features of all the excised specimens, common immune and/or hematopoietic disorders may have contributed to their occurrence and development in association with putative genetic abnormalities.
- Published
- 2015
- Full Text
- View/download PDF
35. [Cysts in the posterior triangle of the neck in adults].
- Author
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Brea-Álvarez B and Roldán-Hidalgo A
- Subjects
- Adult, Branchioma pathology, Carcinoma, Papillary secondary, Cysts diagnostic imaging, Cysts pathology, Female, Head and Neck Neoplasms pathology, Head and Neck Neoplasms secondary, Humans, Lymphangioma pathology, Magnetic Resonance Imaging, Male, Neck diagnostic imaging, Neck pathology, Retrospective Studies, Tomography, X-Ray Computed, Ultrasonography, Young Adult, Branchioma diagnostic imaging, Carcinoma, Papillary diagnostic imaging, Head and Neck Neoplasms diagnostic imaging, Lymphangioma diagnostic imaging, Thyroid Neoplasms pathology
- Abstract
Cystic lesions of the posterior triangle are a pathologic entity whose diagnosis is made in the first two years of life. Its presentation in adulthood is an incidental finding and the differential diagnosis includes cystic lymphangioma, lymphatic metastasis of thyroid cancer and branchial cyst. Often with the finding of a cervical lump, FNA is made before diagnostic imaging is performed, however, this procedure is not always advisable. We reviewed the cases of patients who came last year to our department with a cystic mass in this location and correlating the imaging findings with pathologic specimen. We show characteristic findings of these lesions in order to make an early diagnosis and thus to get the approach and treatment appropriate of adult patients with a cystic lesion in the posterior cervical triangle., (Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.)
- Published
- 2015
- Full Text
- View/download PDF
36. Metastatic squamous cell carcinoma of the gingiva appearing as a solitary branchial cyst carcinoma: diagnostic role of PET/CT.
- Author
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Zhang XX, Zhao K, Zhou SH, Wang QY, Liu JH, and Lu ZJ
- Subjects
- Biopsy, Fine-Needle, Branchioma diagnostic imaging, Branchioma pathology, Carcinoma, Squamous Cell diagnostic imaging, Carcinoma, Squamous Cell surgery, Chemoradiotherapy, Adjuvant, Diagnosis, Differential, Female, Gingival Neoplasms diagnostic imaging, Gingival Neoplasms surgery, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms pathology, Head and Neck Neoplasms secondary, Head and Neck Neoplasms surgery, Humans, Lymph Nodes diagnostic imaging, Lymph Nodes surgery, Lymphatic Metastasis, Magnetic Resonance Imaging, Middle Aged, Multimodal Imaging, Neck Dissection, Predictive Value of Tests, Squamous Cell Carcinoma of Head and Neck, Treatment Outcome, Branchioma diagnosis, Carcinoma, Squamous Cell secondary, Gingival Neoplasms pathology, Head and Neck Neoplasms diagnosis, Lymph Nodes pathology, Positron-Emission Tomography, Tomography, X-Ray Computed
- Abstract
We herein present a case of a left cervical cystic mass, for which the initial pathological diagnosis was branchial cleft cyst carcinoma (following complete mass excision). Thorough postoperative examinations, including with FDG positron emission tomography/computed tomography (PET/CT), revealed a primary tumor in the retromolar region of the left mandible. A 52-year-old female presented with a 2-month history of a painless, progressively enlarged left-sided neck mass. Fine-needle aspiration biopsy suggested a branchial cleft cyst. Physical examination revealed a 3 × 3-cm smooth, tender mass in the upper-left neck and anterior border of the sternocleidomastoid muscle. Examination using nasendoscopy and a strobolaryngoscope revealed no abnormalities of the nasal cavity, nasopharynx, oropharynx, hypopharynx or larynx. MRI of the neck revealed a solitary, round, cystic mass under the left parotid gland. The mass was excised completely. Pathologic results indicated a branchial cleft cyst carcinoma. According to the diagnostic criteria for a branchial cleft cystic carcinoma, PET/CT was performed to detect the occult primary site. PET/CT revealed high FDG uptake in the tooth root of the left mandible. Frozen sections of the mass were indicative of moderate, differentiated squamous cell carcinoma. The carcinoma in the retromolar region of the left mandible was locally excised under general anesthesia. A partial left maxillectomy, partial mandibulectomy, and left radical neck dissection were performed. The patient received postoperative concurrent chemoradiotherapy, and was disease-free at the 8-month follow-up. True branchial cleft cyst carcinoma is rare: once diagnosed, it should be distinguished from metastatic cystic cervical lymph and occult primary carcinoma. FDG PET/CT is useful in the identification of occult primary tumor.
- Published
- 2014
37. [Observing effect of treatment of the second branchial fistula with endoscopic resection].
- Author
-
Jiang J, Wang S, and Tong K
- Subjects
- Adolescent, Aged, Anesthesia, General, Branchioma diagnostic imaging, Female, Head and Neck Neoplasms diagnostic imaging, Humans, Male, Neck, Tomography, X-Ray Computed, Branchioma surgery, Endoscopy, Head and Neck Neoplasms surgery
- Abstract
Objective: To explore synergic effect of treatment of the second branchial fistula with endoscopic resection., Method: All patients of the second branchial fistula were scanned in neck with CT (computed tomography), we injected ioversol-320 from the entrance of the second branchial fistula in front of sternocleidomastiod into the second branchial fistula, then scanned the neck with CT (computed tomography), and rebuilding the picture of the second branchial fistula, to prepare for the operation. 9 patients of the second branchial fistula were operated under general anesthesia with endoscopic resection., Result: All of 9 patients were cured. no one recurred after follow-up of 6 months., Conclusion: It is minimally invasive and complete to resect the second branchial with endoscopic resection, the operation is simply and easy to promote.
- Published
- 2014
38. Watery discharge from the neck ... now that is strange!
- Author
-
Simmons TL
- Subjects
- Branchioma diagnostic imaging, Diagnosis, Differential, Humans, Infant, Male, Physical Examination, Ultrasonography, Branchioma diagnosis, Neck
- Published
- 2013
39. Branchial fistula arising from pyriform sinus: positive esophagogram despite active infection.
- Author
-
Sharma S, Faizi NA, Gupta G, and Sharma D
- Subjects
- Humans, Male, Branchioma diagnostic imaging, Head and Neck Neoplasms diagnostic imaging, Pyriform Sinus diagnostic imaging, Tomography, X-Ray Computed methods
- Published
- 2013
- Full Text
- View/download PDF
40. Thyroid papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst.
- Author
-
Karras S, Anagnostis P, Noussios G, and Pontikides N
- Subjects
- Adult, Branchioma diagnostic imaging, Branchioma surgery, Carcinoma diagnostic imaging, Carcinoma surgery, Carcinoma, Papillary, Diagnosis, Differential, Female, Humans, Thyroid Cancer, Papillary, Thyroid Neoplasms diagnostic imaging, Thyroid Neoplasms surgery, Thyroidectomy, Ultrasonography, Branchioma pathology, Carcinoma pathology, Choristoma diagnostic imaging, Choristoma surgery, Thyroid Gland, Thyroid Neoplasms pathology
- Abstract
Ectopic thyroid tissue comprises a rare clinical entity which can clinically manifest with the whole spectrum of thyroid disorders, including thyroid malignancy. Thyroid carcinoma arising in ectopic thyroid tissue is extremely rare, with only a few cases described in the literature so far. We present a very unusual case of a primary papillary thyroid carcinoma arising in a left lateral branchial cyst, describing our diagnostic and therapeutic approach for this uncommon clinical entity. This is the first case where recombinant thyrotropin was used along with radioiodine treatment in primary ectopic thyroid cancer.
- Published
- 2013
- Full Text
- View/download PDF
41. Pitfalls of CT for deep neck abscess imaging assessment: a retrospective review of 162 cases.
- Author
-
Chuang SY, Lin HT, Wen YS, and Hsu FJ
- Subjects
- Abscess surgery, Adolescent, Adult, Aged, Aged, 80 and over, Branchioma diagnostic imaging, Branchioma surgery, Child, Child, Preschool, Diagnosis, Differential, Drainage, False Positive Reactions, Female, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms surgery, Humans, Infant, Lymph Nodes diagnostic imaging, Lymphatic Metastasis, Male, Middle Aged, Neck, Pharyngeal Diseases diagnostic imaging, Pharyngeal Diseases surgery, Predictive Value of Tests, Retropharyngeal Abscess diagnostic imaging, Retropharyngeal Abscess surgery, Retrospective Studies, Tomography, X-Ray Computed methods, Young Adult, Abscess diagnostic imaging, Cellulitis diagnostic imaging
- Abstract
Objectives: To investigate the diagnostic value of contrast-enhanced computed tomography (CT) for the prediction of deep neck abscesses in different deep neck spaces and to evaluate the false-positive results., Method: We retrospectively analysed the clinical charts, CT examinations, surgical findings, bacteriology, pathological examinations and complications of hospitalised patients with a diagnosis of deep neck abscess from 2004 to 2010. The positive predictive values (PPV) for the prediction of abscesses by CT scan in different deep neck spaces were calculated individually on the basis of surgical findings., Results: A total of 162 patients were included in this study. All patients received both intravenous antibiotics and surgical drainage. The parapharyngeal space was the most commonly involved space. The overall PPV for the prediction of deep neck abscess with contrast-enhanced CT was 79.6%. The PPV was 91.3% when more than one deep neck space was involved but only 50.0% in patients with isolated retropharyngeal abscesses. In the false-positive group, cellulitis was the most common final result, followed by cystic degeneration of cervical metastases. Five specimens taken intra-operatively revealed malignancy and four of these were not infected., Conclusions: There are some limitations affecting the differentiation of abscesses and cellulitis, particularly in the retropharyngeal space. A central necrotic cervical metastatic lymph node may sometimes also mimic a simple pyogenic deep neck abscess on both clinical pictures and CT images. Routine biopsy of the tissue must be performed during surgical drainage.
- Published
- 2013
42. Branchial cleft cyst at an unusual location: a rare case with a brief review.
- Author
-
Panchbhai AS and Choudhary MS
- Subjects
- Child, Contrast Media, Diagnosis, Differential, Female, Follow-Up Studies, Humans, Jugular Veins diagnostic imaging, Radiographic Image Enhancement methods, Submandibular Gland diagnostic imaging, Tomography, X-Ray Computed methods, Branchioma diagnostic imaging, Head and Neck Neoplasms diagnostic imaging, Neck Muscles diagnostic imaging
- Abstract
A branchial cleft cyst (BCC) commonly presents as a solitary, painless mass in the neck of a child or young adult. They are most commonly located along the anterior border and the upper third of the sternocleidomastoid muscle in the anterior triangle of the neck. It is very rare for a BCC to manifest in other locations, especially in the posterior triangle of the neck. BCCs are believed to be derived from the branchial apparatus, mostly from the second branchial arch, although many theories have been proposed to explain the aetiology of BCCs. It is possible for BCCs to be easily misdiagnosed as other swellings of oral or paraoral origin owing to their location. Intraoral lymphoepithelial cysts have also been reported in the literature. It is imperative that clinicians make an accurate diagnosis so that appropriate treatment can be performed. If the cysts are excised properly, recurrence is rare. A rare case report of BCC arising in the neck from an unusual location with components in the posterior triangle is presented here.
- Published
- 2012
- Full Text
- View/download PDF
43. Branchial fistula arising from pyriform fossa: CT diagnosis of a case and discussion of radiological features.
- Author
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Chauhan NS, Sharma YP, Bhagra T, and Sud B
- Subjects
- Adult, Diagnosis, Differential, Humans, Male, Branchioma diagnostic imaging, Head and Neck Neoplasms diagnostic imaging, Pyriform Sinus diagnostic imaging, Tomography, X-Ray Computed methods
- Abstract
Anomalies of third or fourth branchial apparatus origin are very uncommon and present as recurrent neck infections or thyroiditis with a predominant left-sided involvement. Radiological diagnosis requires a high index of suspicion and is critical for initiation of proper treatment. We describe a case of branchial sinus of pyriform fossa with external fistulization that presented in adulthood and was diagnosed on computed tomographic scan. The radiological features of this rare anomaly are revisited., (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
44. Differentiation of branchial cleft cysts and malignant cystic adenopathy of pharyngeal origin.
- Author
-
Goyal N, Zacharia TT, and Goldenberg D
- Subjects
- Adult, Carcinoma, Squamous Cell diagnostic imaging, Chi-Square Distribution, Contrast Media, Diagnosis, Differential, Female, Humans, Lymphatic Metastasis diagnostic imaging, Male, Middle Aged, Pharyngeal Neoplasms diagnostic imaging, Radiography, Retrospective Studies, Branchioma diagnostic imaging
- Abstract
Objective: There is an increasing incidence of head and neck cancers that present as neck masses in a nonsmoking nondrinking population. These masses can be confused with benign cystic neck masses. The purpose of this study was to determine imaging criteria to differentiate benign lateral neck cysts from malignant cystic adenopathy., Materials and Methods: A retrospective analysis of patients who underwent contrast-enhanced neck CT between July 2003 and July 2011 was performed. Patients were diagnosed with either a branchial cleft cyst or pharyngeal squamous cell cancer. Each examination was reviewed by a neuroradiologist, and, for each cyst or cystic lymph node, the anatomic level in the neck, dimensions, wall thickness, septations, homogeneity, extracapsular spread, calcifications, and fat stranding were recorded. Data analysis was performed using Student t tests and chi-square tests., Results: Twenty-one patients with branchial cleft cysts and 29 patients with squamous cell carcinoma met the inclusion criteria. Significant differences between the groups were found with regard to size, homogeneity, and extracapsular spread. Branchial cleft cysts were found to be larger on the long axis (p < 0.001), short axis (p < 0.001), and height (p < 0.001). They were less likely to have extracapsular spread (p = 0.044) or septations (p = 0.059) and more likely to be homogeneous (p < 0.001)., Conclusion: Misdiagnosis of malignant cysts in the neck may lead to delay in diagnosis, a violated neck, tumor spillage, and spread. Differences in radiographic criteria can guide clinical decision making in the patient with a neck mass. However, fine-needle aspiration may be necessary to confirm the diagnosis.
- Published
- 2012
- Full Text
- View/download PDF
45. Cervical branchial cartilaginous remnant.
- Author
-
Choi HJ, Lee JC, and Kim JH
- Subjects
- Branchioma pathology, Cartilage abnormalities, Child, Preschool, Diagnosis, Differential, Female, Humans, Neck surgery, Tomography, X-Ray Computed, Branchioma diagnostic imaging, Branchioma surgery
- Abstract
Failure of proper migration, fusion, or maturation of the branchial apparatus components results in a variety of congenital defects. Most branchial cysts and fistulae are considered to be derived from the first and second branchial clefts. Of these, cervical cartilaginous rests are infrequent, whereas branchial cysts and sinuses are relatively more common. Our patient, a 4-year-old girl, had been operated on with simple skin excision and excision of the combined platysma. Finding from histopathology revealed a hyaline cartilage. Cervical branchial remnants do not have fistulous tracts or connections with important deeper organs; hence, they can be safely transected at the level of the superficial musculature. Therefore, we believe that the most important points are optimal incision for branchial cartilaginous remnants and surgical excision with preservation of the normal anatomy.
- Published
- 2012
- Full Text
- View/download PDF
46. An unusual otoscopic finding associated with a type II first branchial cleft anomaly.
- Author
-
Ebelhar AJ and Potts K
- Subjects
- Branchial Region diagnostic imaging, Branchial Region surgery, Branchioma diagnostic imaging, Branchioma pathology, Child, Drainage, Ear Canal surgery, Female, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms pathology, Humans, Microscopy, Neck, Otoscopy, Radiography, Reoperation, Tympanic Membrane abnormalities, Tympanic Membrane surgery, Abscess surgery, Branchial Region abnormalities, Branchioma surgery, Ear Canal abnormalities, Head and Neck Neoplasms surgery, Parotid Diseases surgery
- Abstract
Objective: We report an interesting case involving a child with a branchial cleft anomaly with two fistulous tracts, one of which was associated with an unusual otoscopic finding., Case Report: A seven-year-old girl presented with an apparent type II first branchial cleft cyst after an acute infection. Parotidectomy and excision of the tract were performed, with subsequent development of pre-auricular swelling three months later. Further surgery was performed to remove a second duplication anomaly of the external auditory canal. Otomicroscopy showed a fibrous band arising from the wall of the canal and attached to the tympanic membrane at the umbo., Conclusion: Otoscopic findings on physical examination can be important diagnostic clues in the early recognition of branchial cleft anomalies. The classification system proposed by Work may fail to describe some branchial cleft lesions.
- Published
- 2012
- Full Text
- View/download PDF
47. [Diagnosis and surgical operation for fourth branchial cleft anomalies].
- Author
-
Zhu T and Hua Q
- Subjects
- Adult, Branchial Region diagnostic imaging, Branchial Region surgery, Female, Humans, Male, Middle Aged, Radiography, Retrospective Studies, Young Adult, Branchial Region abnormalities, Branchioma diagnostic imaging, Branchioma surgery
- Abstract
Objective: To explore diagnosis and surgical operation through analyzing clinical features of the fourth branchial cleft anomalies., Method: Clinical materials of 10 patients with the fourth branchial cleft anomalies were retrospectively analyzed, and literatures were studied to explore the diagnosis, differential diagnosis and treatment methods of surgical operation; lesions of 10 patients were completely removed by surgical operation, and internal sinus was properly handled., Result: All 10 cases were cured, no recurrence were observed during a follow-up of 1-3 years. 1 patient appeared low voice, and drinking cough, back to normality after 2 weeks; 1 patient appeared paralysis of left hypoglossal nerves, back to normality after 3 months., Conclusion: Recurrent deep neck abscess and chronic sinus infections of anterior area in the lower part of neck should be considered with the diagnosis of the fourth branchial cleft anomalies. Enhanced neck CT scan and barium sulfate meal examination aid to diagnosis, pathological examination can be confirmed. Complete surgical removal of lesions is an effective treatment of fourth branchial cleft anomalies, knowing of the courses of internal sinus and spread of infection, and use of principle of selective neck dissection is the key to ensure complete removal of lesions.
- Published
- 2011
48. Pathology quiz case 3. First branchial apparatus cyst, type II.
- Author
-
Shuman AG, Nelson ME, Rabah R, and Thorne MC
- Subjects
- Branchioma diagnostic imaging, Branchioma surgery, Child, Facial Nerve surgery, Female, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms surgery, Humans, Tomography, X-Ray Computed, Branchioma pathology, Head and Neck Neoplasms pathology
- Published
- 2011
- Full Text
- View/download PDF
49. Deep neck infections of congenital causes.
- Author
-
Nour YA, Hassan MH, Gaafar A, and Eldaly A
- Subjects
- Adolescent, Adult, Branchioma diagnostic imaging, Branchioma microbiology, Child, Child, Preschool, Female, Humans, Male, Middle Aged, Respiratory Tract Infections diagnostic imaging, Respiratory Tract Infections etiology, Retrospective Studies, Soft Tissue Infections diagnostic imaging, Thyroglossal Cyst diagnostic imaging, Thyroglossal Cyst microbiology, Tomography, X-Ray Computed, Young Adult, Branchioma complications, Head and Neck Neoplasms diagnostic imaging, Head and Neck Neoplasms microbiology, Neck diagnostic imaging, Pyriform Sinus diagnostic imaging, Pyriform Sinus microbiology, Soft Tissue Infections etiology, Thyroglossal Cyst complications
- Abstract
Objectives: To review cases of deep neck infections with underlying congenital etiology with special emphasis on their clinical presentations and the computed tomographic findings and to discuss the various therapeutic modalities employed for such lesions., Study Design: Case series with chart review., Settings: Alexandria University Hospital, Egypt., Subjects and Methods: The authors retrospectively reviewed the clinical, imaging, and operative records of deep neck infection cases presented to their department in the past 10 years. Deep neck infection cases due to congenital causes were included in the study. RESULTS Of the 249 cases of deep neck infections admitted to the authors' department in the past 10 years, 39 patients were diagnosed with deep neck infections due to congenital causes. Patients were classified into 2 groups. In group 1 (29 patients), computed tomography revealed the presence of infected cystic swelling in the neck that was classified as second branchial cyst (16 patients), third and fourth branchial cysts (8 patients), and thyroglossal cyst (5 patients). Group 2 (10 patients) presented with recurrent attacks of deep neck infection with a history of incision and drainage several times. Radiological and operative findings revealed the presence of congenital pyriform fossa sinus., Conclusion: Computed tomography is helpful in diagnosing infected congenital cysts and its types. Infected congenital cysts could be excised completely under an umbrella of antibiotics. Recurrence of deep neck infections should alert the physician to the possibility of underlying congenital lesions. Thorough clinical and radiological assessment is mandatory to rule out the possibility of a congenital pyriform fossa sinus.
- Published
- 2011
- Full Text
- View/download PDF
50. Treatment of a branchial sinus tract by sclerotherapy.
- Author
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Nixon PP and Healey AE
- Subjects
- Adolescent, Branchioma diagnostic imaging, Female, Humans, Radiography, Sclerosing Solutions therapeutic use, Sodium Tetradecyl Sulfate therapeutic use, Branchioma therapy, Cutaneous Fistula therapy, Sclerotherapy methods
- Abstract
A 16-year-old female presented with a sinus on the skin just medial to the right clavicle, which had discharged clear fluid on a daily basis for a number of years. A sinogram was performed and showed a long sinus tract extending from the region of the right clavicle to the lateral pharyngeal wall. Surgical treatment would have required an extensive procedure and seemed inappropriate in view of the relatively mild symptoms the patient was experiencing. Instead sclerotherapy was used to induce healing of the lesion. This was performed using 3% sodium tetradecyl sulphate foam delivered via a catheter along the entire length of the tract. There were no immediate complications from this procedure and on review at 1 and 6 weeks post-procedure the patient reported a significant improvement in the fluid discharge. At 1 year post-procedure this improvement had been sustained. The patient did report an occasional discharge from the sinus tract orifice at the base of her neck, but she did not feel that this was a significant problem and declined any further treatment.
- Published
- 2011
- Full Text
- View/download PDF
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