Cervical node metastases presenting with features of branchial cysts

Cystic lymph node metastases of squamous cell carcinoma of Waldeyer’s ring origin

“…Some of the cervical LN metastases feature prominent cyst formation. Solitary cystic LN metastases have often been mistaken for primary squamous cell carcinomas (SCC) originating within a branchiogenic lateral neck cyst (LNC), resulting in the commonly used terms 'branchioma' and 'branchiogenic carcinoma ' (von Volkmann, 1882;Wolff et al, 1979;Khafif et al, 1989;Parks and Karmody, 1992;Carroll et al, 1993;Hall and Dexter, 1993;Flanagan et al, 1994;Knobber et al, 1995). For patients with an isolated finding of SCC in a neck LN, a search for a primary carcinoma in the upper aerodigestive tract is mandatory, including US, MRI and CT, as well as extensive biopsies of the base of tongue, nasopharynx and tonsillectomies in the case of clinically occult tumours (Spiro et al, 1983;Flanagan et al, 1994).…”

“…Solitary cystic LN metastases have often been mistaken for primary squamous cell carcinomas (SCC) originating within a branchiogenic lateral neck cyst (LNC), resulting in the commonly used terms 'branchioma' and 'branchiogenic carcinoma ' (von Volkmann, 1882;Wolff et al, 1979;Khafif et al, 1989;Parks and Karmody, 1992;Carroll et al, 1993;Hall and Dexter, 1993;Flanagan et al, 1994;Knobber et al, 1995). For patients with an isolated finding of SCC in a neck LN, a search for a primary carcinoma in the upper aerodigestive tract is mandatory, including US, MRI and CT, as well as extensive biopsies of the base of tongue, nasopharynx and tonsillectomies in the case of clinically occult tumours (Spiro et al, 1983;Flanagan et al, 1994). This clinical practice has provided overwhelming evidence in recent years that isolated cystic SCC in neck LN are metastases from primary SCC of the palatine tonsils, the base of the tongue and the nasopharynx, tissues also collectively referred to as the Waldeyer's ring (Micheau et al, 1974(Micheau et al, , 1990Flanagan et al, 1994;Thompson and Heffner, 1998).…”

“…For patients with an isolated finding of SCC in a neck LN, a search for a primary carcinoma in the upper aerodigestive tract is mandatory, including US, MRI and CT, as well as extensive biopsies of the base of tongue, nasopharynx and tonsillectomies in the case of clinically occult tumours (Spiro et al, 1983;Flanagan et al, 1994). This clinical practice has provided overwhelming evidence in recent years that isolated cystic SCC in neck LN are metastases from primary SCC of the palatine tonsils, the base of the tongue and the nasopharynx, tissues also collectively referred to as the Waldeyer's ring (Micheau et al, 1974(Micheau et al, , 1990Flanagan et al, 1994;Thompson and Heffner, 1998). Although this explanation has been slow to gain wide recognition and claims of the first true 'branchiogenic carcinoma' have been made rather recently (Micheau et al, 1974;Jones et al, 1993), cystic SCC in cervical LN is now regarded as a typical presentation of metastatic SCC arising in the oro/nasopharynx.…”

Lateral cervical cysts: anAustralian perspective

“…Secondly, BC cysts are most common and present as a swelling in the lateral neck, anterior to the border of the sternomastoid muscle. SCC of the oropharynx, particularly the lymphatic tissue of Waldeyers ring, commonly metastasises to the deep cervical lymph nodes . These metastases have a predisposition to undergo cystic degeneration and commonly present without a symptomatic primary lesion .…”

Second Branchial Cyst: A Rare Presentation

“…In patients over the age of 40yrs a cystic metastatic node from a primary neoplasm has to be excluded. [10] Other differential diagnosis are Lymphoma, Tuberculosis, carotid body tumor. Ultrasonography is the primary investigation of choice for these types of cystic lesions.…”