Excision of rare adult cervical thymic cyst

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.

Type I second branchial cleft cyst in an adult patient

Branchial cleft anomalies are rare diseases of head and neck region. Second branchial cleft anomalies represent more than 95% of all branchial cleft anomalies. Second branchial cleft cyst is a benign developmental cyst due to the incomplete obliteration of pharyngeal cleft. A 46-year-old female patient reported to hospital with a complaint of swelling over the left side of the neck since 4 to 5 months. On clinical examination, swelling was seen below and behind the angle of mandible on the left side. The patient was evaluated using ultrasound and contrast enhanced computerized tomography (CECT) of neck which revealed second left bronchial cleft cyst/enlarged cystic lymph-node. Fine needle aspiration cytology of the swelling showed features of cystic lesion. Type-I branchial cleft cyst is a rare condition with a significant risk of misdiagnosis. To avert misdiagnosis and surgical complications, thorough investigation must be performed prior to surgical intervention.

A Case of Nontuberculous Mycobacterial Infection on Branchial Cleft Cyst

Nontuberculous mycobacteria (NTM) is commonly found in the surrounding environment and can cause opportunistic infection. Mainly, it causes lymph node infection in the cervical area, which is often known to occur in children. Recently, we have experienced a case of NTM infection on a branchial cleft cyst in a 36-year old male. NTM was diagnosed by fine needle aspiration and branchial cleft cyst was confirmed by postoperative pathologic findings. We report this case with a review of literature.