A rare case of a branchial cyst with calcification: A case report

Kato,Tomoki; Yamada,Michihiro; Watanabe,Takuma; Nakao,Kazumasa

doi:10.3892/etm.2023.12065

A rare case of a branchial cyst with calcification: A case report

Authors:
- Tomoki Kato
- Michihiro Yamada
- Takuma Watanabe
- Kazumasa Nakao
View Affiliations

Affiliations: Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Kyoto University, Kyoto 606‑8507, Japan
Published online on: June 14, 2023 https://doi.org/10.3892/etm.2023.12065
Article Number: 366

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Branchial cysts are relatively rare lesions with lymphoid tissue in the underlying epithelium of the cyst wall. The present study describes the case of a branchial cyst with keratinization and calcification that occurred in the right submandibular region, along with a review of the literature. A 49‑year‑old female patient presented with a complaint of swelling in the right submandibular region. Computed tomography revealed a well‑defined, cystic lesion located anterior to the sternocleidomastoid muscle, outside the hyoid bone, and in front of the submandibular gland. The cystic cavity presented an opaque image suggestive of calcification. Magnetic resonance imaging showed high‑intensity lesions on both T2‑weighted and short‑τ inversion recovery images on the anterior margin of the right sternocleidomastoid muscle, just below the platysma muscle, with a clear demarcation from the surrounding tissue, and posterior compression and flattening of the submandibular gland. Cystectomy was performed under general anesthesia, and histopathological examination confirmed the diagnosis of branchial cyst with keratinized and calcified substances. The patient recovered well and had no complications or recurrence at ~2‑year follow‑up. This case highlights the rare occurrence of a branchial cyst containing calcification in the cystic cavity and provides a literature review of the factors contributing to the calcification.

View Figures

View References

1	Skolnik EM, Loewy A and Ferrer J: Swellings of the neck. Arch Otolaryng. 81:150–152. 1965.PubMed/NCBI View Article : Google Scholar
2	Ascherson FM: De fistulis colli congenitis adjectis fissurarum branchialium in mammalibus avibusque historia succincta. Berolini. CH Jonas, pp1-22, 1832.
3	Simpson RA: Lateral cervical cysts and fistulas. Laryngoscope. 79:30–59. 1969.PubMed/NCBI View Article : Google Scholar
4	Bhaskar SN and Bernier JL: Histogenesis of branchial cysts; a report of 468 cases. Am J Pathol. 35:407–443. 1959.PubMed/NCBI
5	Glosser JW, Pires CAS and Feinberg SE: Branchial cleft or cervical lymphoepithelial cysts: Etiology and management. J Am Dent Assoc. 134:81–86. 2003.PubMed/NCBI View Article : Google Scholar
6	Yang X, Ow A, Zhang CP, Wang LZ, Yang WJ, Hu YJ and Zhong LP: Clinical analysis of 120 cases of intraoral lymphoepithelial cyst. Oral Surg Oral Med Oral Pathol Oral Radiol. 113:448–452. 2012.PubMed/NCBI View Article : Google Scholar
7	Camilleri AC and Lloyd RE: Lymphoepithelial cyst of the parotid gland. Br J Oral Maxillofac Surg. 28:329–332. 1990.PubMed/NCBI View Article : Google Scholar
8	Howie AJ and Proops DW: The definition of branchial cysts, sinuses and fistulae. Clin Otolaryngol Allied Sci. 7:51–57. 1982.PubMed/NCBI View Article : Google Scholar
9	Golledge J and Ellis H: . The aetiology of lateral cervical (branchial) cysts: Past and present theories. J Laryngol Otol. 108:653–659. 1994.PubMed/NCBI View Article : Google Scholar
10	Daou FS: Branchial cyst: An often forgotten diagnosis. Asian J Surg. 28:174–178. 2005.PubMed/NCBI
11	McPhail N and Mustard RA: Branchial cleft anomalies: A review of 87 cases treated at the Toronto General Hospital. Can Med Assoc J. 94:174–179. 1966.PubMed/NCBI
12	Agaton-Bonilla FC and Gay-Escoda C: Diagnosis and treatment of branchial cleft cysts and fistulae. A retrospective study of 183 patients. Int J Oral Maxillofac Surg. 25:449–452. 1996.PubMed/NCBI View Article : Google Scholar
13	Rickles NH and Little JW: The histogenesis of the branchial cyst. II. A study of the lining epithelium. Am J Pathol. 50:765–777. 1967.PubMed/NCBI
14	Chen WL and Fang SL: Removal of second branchial cleft cysts using a retroauricular approach. Head Neck. 31:695–698. 2009.PubMed/NCBI View Article : Google Scholar
15	Bajaj Y, Ifeacho S, Tweedie D, Jephson CG, Albert DM, Cochrane LA, Wyatt ME, Jonas N and Hartley BE: Branchial anomalies in children. Int J Pediatr Otorhinolaryngol. 75:1020–1023. 2011.PubMed/NCBI View Article : Google Scholar
16	Stefanicka P and Profant M: Branchial cleft cyst and branchial cleft cyst carcinoma, or cystic lymph node and cystic nodal metastasis? J Laryngol Otol. 137:31–36. 2023.PubMed/NCBI View Article : Google Scholar
17	King ESJ: The lateral lympho-epithelial cyst of the neck; branchial cyst. Aust N Z J Surg. 19:109–121. 1949.PubMed/NCBI View Article : Google Scholar
18	Nonaka CF, Henriques AC, de Matos FR, de Souza LB and Pinto LP: Nonodontogenic cysts of the oral and maxillofacial region: Demographic profile in a Brazilian population over a 40-year period. Eur Arch Otorhinolaryngol. 268:917–922. 2011.PubMed/NCBI View Article : Google Scholar
19	Gold C: Branchial cleft cyst located in the floor of the mouth. Report of a case. Oral Surg Oral Med Oral Pathol. 15:1118–1120. 1962.PubMed/NCBI View Article : Google Scholar
20	Bhaskar SN: Lymphoepithelial cysts of the oral cavity. Report of twenty-four cases. Oral Surg Oral Med Oral Patho. 21:120–128. 1966.PubMed/NCBI View Article : Google Scholar
21	Bailey H: The clinical aspects of branchial cysts. Br J Surg. 10:565–572. 2005.
22	Regauer S, Gogg-Kamerer M, Braun H and Beham A: Lateral neck cysts-the branchial theory revisited. A critical review and clinicopathological study of 97 cases with special emphasis on cytokeratin expression. APMIS. 105:623–630. 1997.PubMed/NCBI
23	Chandler JR and Mitchell B: Branchial cleft cysts, sinuses, and fistulas. Otolaryngol Clin North Am. 14:175–186. 1981.PubMed/NCBI
24	Olsen KD, Maragos NE and Weiland LH: First branchial cleft anomalies. Laryngoscope. 90:423–436. 1980.PubMed/NCBI View Article : Google Scholar
25	Miller MA and Zachary JF: Mechanisms and morphology of cellular injury, adaptation, and death. Pathologic Basis Vet Dis. 2-43(e19)2017.
26	Yoon JH, Ahn SG, Kim SG and Kim J: Calcifications in a clear cell mucoepidermoid carcinoma of the hard palate. Int J Oral Maxillofac Surg. 34:927–929. 2005.PubMed/NCBI View Article : Google Scholar