ABSTRACT
Branchial cleft anomalies represent a common cause of cervical mass in adults. Describing a case report, we reviewed embryology, clinical elements, and treatment options for parapharyngeal congenital cysts. A case of a parapharyngeal cyst mimicking a tonsillar abscess is presented. A second branchial cleft cyst was hypothesized on a clinical and radiologic basis and then confirmed by histologic data. Magnetic resonance imaging provided fundamental information for the study of the parapharyngeal mass and its relationship with surrounding structures. In literature, surgical excision is the recommended therapy. We removed the cyst through a transcervical approach, with no complications or recurrence after 3 years. In our opinion, cervicotomy should be considered the gold standard approach, even for lesions not palpable in the cervical area. When dealing with a parapharyngeal cyst, second branchial cleft anomalies should be considered. Our experience confirms that cervicotomy is a safe approach to parapharyngeal congenital lesions.
Subject(s)
Branchioma/diagnosis , Pharyngeal Neoplasms/diagnosis , Adult , Branchioma/embryology , Branchioma/surgery , Diagnosis, Differential , Epithelium/pathology , Female , Follow-Up Studies , Head and Neck Neoplasms/diagnosis , Head and Neck Neoplasms/embryology , Head and Neck Neoplasms/surgery , Humans , Lymphoid Tissue/pathology , Magnetic Resonance Imaging , Neck/surgery , Peritonsillar Abscess/diagnosis , Peritonsillar Abscess/microbiology , Pharyngeal Neoplasms/embryology , Pharyngeal Neoplasms/surgery , Recurrence , Streptococcal Infections/diagnosisABSTRACT
The purpose of this study is to clarify the origin and nature of so-called hairy polyps or dermoids of the pharynx, which are often thought to be a variant of pharyngeal teratoma. For this purpose, a case is reported of a dermoid polyp involving the middle ear of an infant, the features of multiple examples of pharyngeal dermoid polyps and teratomas received for consultation by the Armed Forces Institute of Pathology are examined, and selected pertinent reports from the literature are reviewed. All three means are used to support the conclusion that these lesions are choristomatous developmental anomalies arising from the first branchial cleft area and that they essentially represent heterotopic accessory "ears" (auricles) without the growth potential of a teratoma.
Subject(s)
Choristoma/classification , Dermoid Cyst/classification , Ear, External , Pharyngeal Neoplasms/classification , Pharynx , Branchioma/classification , Dermoid Cyst/embryology , Dermoid Cyst/surgery , Ear, Middle/pathology , Female , Head and Neck Neoplasms/classification , Humans , Infant , Pharyngeal Neoplasms/embryology , Pharyngeal Neoplasms/surgeryABSTRACT
The study of the branchial remnants needs a perfect understanding of the embryology of the branchial apparatus. Endoscopic excision using the CO2 laser in a very rare case of third pouch sinus is reported for the first time.
