Casas J¹*, Garriga E², Agüero N³ and Daboin I⁴

¹Otolaryngology and Head and Neck Surgery, Grupo Médico Santa Paula, Caracas, Venezuela
²Head and Neck Surgery, Grupo Médico Santa Paula, Caracas, Venezuela
³Thoracic Surgery, Grupo Médico Santa Paula, Caracas, Venezuela
⁴Anatomopathologist, Grupo Médico Santa Paula, Caracas, Venezuela

*Corresponding Author: Casas J, Otolaryngology and Head and Neck Surgery, Grupo Médico Santa Paula, Caracas, Venezuela.

Received: April 27, 2024 Published: July 31, 2024

Abstract

Branchial cleft cysts are growths that may develop abnormally from the branchial apparatus, a structure that forms the embryonic precursors for the neck tissue. Although these growths are commonly observed in children, they can also affect adults. However, there is limited information available on the adult population that undergoes branchial cleft excision. The cervical area, located anterior to the sternomastoid muscle in the upper or middle portion of the neck, is the most common anatomical site for the appearance of branchial cleft cysts. It is worth noting that mediastinal branchial cleft cysts are extremely rare and only a few cases are reported. Misdiagnosis of the fourth branchial cleft anomaly is widespread and often leads to inappropriate treatment.
We present a case of a 67-year-old woman who had a cystic mass situated below her left thyroid lobe and posterior to the sternum. The patient had painless swelling for the past seven months. Imaging tests revealed a cystic between the thyroid and the aortic arch. The patient underwent complete excision of the lesion through a neck dissection and a sternotomy, and the postoperative histopathological examination confirmed the diagnosis of the branchial cleft cyst. The patient had a successful recovery without any recurrence at the six-month follow-up.
The course of the sinus track indicates that this was a fourth branchial cleft cyst. These are the rarest among the branchial anomalies, and the extension below the peri-thyroid region to the mediastinum is infrequently described. To prevent misdiagnosis and ensure proper treatment, a systematic literature review (PubMed, Cochrane, ResearchGate) was conducted in English and Spanish to summarize the clinical features of the fourth branchial cleft cyst and identify the best options for diagnosis and treatment.

Keywords: Fourth Branchial Cleft Cyst; Branchial Anomalies; Mediastinal Cyst

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Citation

Citation: Casas J. “Discover the Uncommon: A Case Report and Systematic Review of a Neck and Mediastinum Tumor in the Elderly".Acta Scientific Otolaryngology 6.8 (2024): 47-52.

Copyright

Copyright: © 2024 Casas J. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.