A Case report of Branchial cleft cyst in 22 years old male

Branchial cleft cyst is a slow-growing fluctuant mass that most commonly appears during the second and third decades of life. The most common site of this cyst is the lateral aspect of the neck and anterior to the sternocleidomastoid muscle, but it can also be found around the parotid gland, angle of the mandible and near the external ear. The cyst presented in this case report is important because of its uncommon site and its clinical presentation similar to an odontogenic abscesses, possibly leading to clinical misdiagnosis.
Case Report: This report presents a case of a branchial cleft cyst which was misdiagnosed primarily as an odontogenic cyst or abscess and was treated with antibiotics for three months by a general dentist. In clinical examination there was a 5×5-cm fluctuant swelling with soft consistency in the lateral aspect of the neck and right side of submandibular area. The cyst was not tender to palpation. The panoramic view showed extensive caries of the right first molar tooth and a radiolucent lesion in the apical area of the right third molar. Following determination of the extension of this lesion by spiral CT scan, excisional biopsy was carried out under general anesthesia. Pathology report revealed branchial cleft cyst.
The diagnosis of branchial cleft cysts mainly depends on history and clinical manifestations. CT scan is not only useful for the evaluation of the lesion but also it is useful to evaluate its relationship with adjacent structures.