An unusual presentation of a branchial cleft cyst in a 70-year-old

Abstract

Background: Branchial cleft cysts are common congenital head and neck masses predominantly presenting in a pediatric setting. Most branchial cleft cysts do not provide a diagnostic challenge as they have consistent physical locations and clinical presentation. This paper describes a rare case of branchial cleft cyst isolated in the parapharyngeal space. To our knowledge, this is the oldest presentation of a parapharyngeal space branchial cleft cyst in the literature. Case: A 70-year-old non-smoking gentleman presented with a subacute presentation of dysphagia and odynophagia. Physical examination revealed a right posterior oropharyngeal swelling. On imaging he was found to have a 4.6cm cystic, right parapharyngeal mass abutting the prevertebral fascia. Fine needle aspirate suggested benign pathology. Surgical resection was pursued and final pathology was consistent with a branchial cleft cyst. Discussion: Benign congenital branchial cleft cysts should be considered in the differential diagnosis for parapharyngeal masses, regardless of age.

Keywords

• Branchial cleft
• Parapharyngeal space