Branchial Cleft Cyst Clinical Presentation

Updated: Jun 02, 2020
  • Author: Chih-Ho Hong, MD, FRCPC; Chief Editor: William D James, MD  more...
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A branchial cyst commonly presents as a solitary, painless mass in the neck of a child or a young adult. A history of intermittent swelling and tenderness of the lesion during upper respiratory tract infection may exist. Discharge may be reported if the lesion is associated with a sinus tract.

In some instances, branchial cleft cyst patients may present with locally compressive symptoms. A family history of branchial cleft cysts may be present.


Physical Examination

Primary branchial cleft cyst lesion: Branchial cysts are smooth, nontender, fluctuant masses, which occur along the lower one third of the anteromedial border of the sternocleidomastoid muscle between the muscle and the overlying skin.

Secondary branchial cleft cyst lesion: The lesion may be tender if secondarily inflamed or infected. When associated with a sinus tract, mucoid or purulent discharge onto the skin or into the pharynx may be present.

Rarely, branchial cleft cysts have been reported as fluctuant nodules on the thorax, [8] and even in the posterior mediastinum. [9]