Branchial Cyst

  • Medical Author:
    John Mersch, MD, FAAP

    Dr. Mersch received his Bachelor of Arts degree from the University of California, San Diego, and prior to entering the University Of Southern California School Of Medicine, was a graduate student (attaining PhD candidate status) in Experimental Pathology at USC. He attended internship and residency at Children's Hospital Los Angeles.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

What facts should I know about a branchial cyst?

A branchial cyst is a cavity that is a congenital remnant from embryologic development. It is present at birth on one side of the neck and is located just in front of the large angulated muscle on either side of the neck running from just behind the ear down to the clavicle (collarbone). This muscle is called the sternocleidomastoid muscle. The cyst may not be recognized until adolescence as it enlarges and assumes its oval shape. Such a sinus tract may either have a small dimple or skin tag at the opening. The cyst is a smooth, soft and nontender structure.

A branchial cyst is also called branchial cleft cyst.

What are symptoms of a branchial cyst?

Branchial cysts usually cause no immediate problem. They can cause a pressure sensation in the area affected. Sometimes it develops a sinus or drainage pathway to the surface of the skin from which mucus can be expressed. They are typically not tender. Rarely, however, they can become infected.

Cystic Acne on the face

What Is the Treatment For a Cyst?

The treatment for a cyst depends on the underlying cause of the cyst and whether or not the cyst is causing the patient problems. As stated previously, many cysts are benign and require no treatment. However, large cysts can result in symptoms due to compression of normal tissue and obstruction of ducts. Some of these cysts can be treated by simply aspirating the cyst contents through a needle or catheter, thereby collapsing the cyst. Other cysts require surgical removal (some cysts like ovarian cysts can be removed by laparoscopic surgery), especially if there's any suspicion of malignancy. In general, cysts that cause symptoms are treated by draining them and/or removing them surgically; medical treatment is usually limited to reducing associated symptoms of their underlying cause(s). Individuals should discuss with their doctors about the best methods to use to get rid of their cysts.

What are structures in the neck that can be similar to a branchial cyst?

There can be other structures in the neck area of a similar character. These include

  1. Cystic hygroma: This structure is a malformation of the lymphatic system in the neck region. The lymphatic system is composed of a series of vessels that drain a milky white liquid (lymph) that contains fluid and white blood cells for fighting infection. In comparison with a branchial cleft cyst, a cystic hygroma is also smooth and soft but is located behind the sternocleidomastoid muscle.
  2. Thyroglossal duct cyst: This structure commonly drains from inside the floor of the mouth to an opening similar to that of a branchial cleft cyst, but it's located in the center of the neck in the area of the larynx (voice box).
  3. Swelling of the thyroid gland: This soft structure has two lobes that are located on either side of the windpipe (trachea) at the level of the vocal cords. There is a thin connection of thyroid tissue that bridges the two lobes and crosses over the trachea.
  4. Miscellaneous: collections of fat (lipomas), collections of blood vessels (hemangiomas), sebaceous cysts, etc.

How is a branchial cyst treated?

Total surgical excision is the treatment of choice. Recurrence is not expected.

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References
Medically reviewed by Margaret Walsh, MD; American Board of Pediatrics

REFERENCE:

"Differential diagnosis of a neck mass"
uptodate. Updated Aug. 30, 2016
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