Choristoma: Cervical Chondrocutaneous Branchial Remnants

Abstract

Unilateral cervical chondrocutaneous branchial remnants (CCBRs) are rare, but when present, are typically located over the lateral aspect of the neck along the anterior margin of the sternocleidomastoid muscle. A CCBR in this location is called a choristoma. Here, we describe a choristoma in a 25-year-old female who disclosed a documented diagnosis of Meniere’s disease, and an expressed interest in bearing children within the immediate future. She presented with a unilateral swelling, located subcutaneously, midway over the anterior margin of the right sternocleidomastoid muscle. Due to her history, and the risk of possible radiological exposure to her fetus, an ultrasound-based examination of the neck and cardio-abdomino-pelvic organs was performed. Our clinical findings, details of the ultrasound results, and surgical data will be described.

Sonographic Findings of Cervical Chondrocutaneous Branchial Remnants—A Comparison With Dermal Lesions/Cysts and a Literature Review

“…Only three lesions could be evaluated for an association between the lesion and the underlying muscle. 24,27 According to previous and current cases, low-echoic CCBR lesions include mass-or tubular-like shapes. In our cases, the lesion shape depended upon the shape of the cartilage.…”

“…Various pathogenic mechanisms of CCBRs have been hypothesized, including ectopic auricular tissues resulting from the failed fusion of the hillocks of the first and second branchial arches that have migrated or residual cartilage from the second or lower branchial arches. 1,[3][4][5][6][7]9,12,25,27,29,30,32 These lesions are located adjacent to the SCM. In our limited cohort, there was only one right-sided lesion but eight leftsided lesions, which is consistent with the dominant incidence of branchial anomalies on the left side compared with that of those on the right side.…”

“…13 We reviewed previous studies that focused on ultrasonographic findings (Table 3). 9,11,12,[24][25][26][27] Some case reports did not display the sonograms; however, nine lesions were mentioned in the ultrasonographic findings of seven cases. Eight were lowechoic mass-like lesions, whereas one was a low-echoic tubular-like lesion.…”

“…In previous reports describing sonographic findings, only two patients presented an association between the CCBR lesion and the SCM. 9,11,12,[24][25][26][27] However, some reports focused on this association in surgical or pathological findings. 1,3 In our patients with CCBRs, we could show an association between the lesion and the SCM.…”

“…Ultrasonography is widely used for pediatric patients because of its high resolution and bedside performance without irradiation and sedation. 23 Although some case reports have been published, 9,11,12,[24][25][26][27] to the best of our knowledge, clinical studies focusing on imaging findings of CCBRs in pediatric patients are lacking. Therefore, we aimed to demonstrate the usefulness of ultrasonography for the diagnosis and evaluation of CCBRs to differentiate them from other cervical dermal lesions in pediatric patients.…”