Mixed Pleomorphic Adenoma (Differential Diagnosis Second Branchial Cyst)

Figure tuha_22a_n.jpg to tuha_22c_n.jpg: Inflammatory and mainly neoplastic lesions of the salivary glands, too, belong to the differential diagnosis of a second branchial cyst. Figure tuha_22a_n.jpg: This is mainly true for unilateral acute and chronic inflammations of the submandibular gland and for the mixed pleomorphic adenoma. This 3.5-year-old boy had such a tumor, although he is too young for a semi-malignant mixed pleomorphic adenoma with the preferred age between 5 and 15 years. The skin changes (phlebectasia), shape and consistency (rough with a continuation under the angle of the lower jaw), and the observed gradual growth make a cystic lymphangioma or a second branchial cyst unlikely. Figure tuha_22b_n.jpg: A similar mixed adenoma may occur rarely on the neck beyond the salivary glands and reminds of a second branchial cyst because of its localization, as was the case in this 8.4-year-old girl. Figure tuha_22c_n.jpg: Sectional plane of the excised tumor.