Lateral Mass (Branchial Cyst)

Figure tuha_10a_n.jpg: The visible mass in this 1-year-old patient lies on the right side, laterally to the midline. Figure tuha_10b_n.jpg: In an oblique view it lies in the upper part of the sternocleidomastoid muscle whose lower part is clearly visible. The mass is solid and cystic on palpation and its overlying skin is non-irritant. These findings fit the picture of a congenital malformation, and considering the young age, do not fit an acquired pathology in spite of the site near the angle of the lower jaw (lymphadenopathy or lesion of the submandibular gland). Most probably, it is a branchiogenic cyst = second branchial anomaly due to the topographic relation to the sternocleidomastoid muscle. Concerning the visible aspect, a cystic lymphangioma is not excluded, in contrast to a tumor of sternocleidomastoid muscle, because the patient is not a newborn, the mass is not rough, and has no continuation into the muscle in the cranial and caudal direction; $$scha_4??££see figure for comparison.§§