Branchial Cyst Masquerading as Myositis and Abscess of Sternocleidomastoid Muscle and Necrotic-Cystic Lymphadenopathy

Branchial cleft cysts are considered one of the most common cystic lesions in neck and are commonly seen in pediatric age group and young adulthood with most of the cases presenting within second and third decade. Here we intend to discuss a case of a 43 year old male who presented with a very short history of a painful lateral neck mass and was clinico-radiologically suggested as either myositis and abscess of sternocleidomastoid muscle or necrotic/cystic lymphadenopathy. An ultrasound guided needle aspiration cytology did not show any microorganism thus an excisional biopsy of the mass was done suspecting it to be lymph nodal mass. However the histopatholgical examination confirmed it to be an inflamed branchial cyst. Thus we would like to highlight the importance of keeping branchial cleft cysts as a possible differential while managing lateral neck masses of any duration in adults as well as in children.