The First Branchial Cleft Carcinoma

Park, Stephen S.; Karmody, Collin S.

doi:10.1001/archotol.1992.01880090085022

Cited by 31 publications

(29 citation statements)

References 13 publications

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“…During the last 5 years, we had not had a single case of an isolated solitary cystic carcinoma without an immediately evident primary carcinoma, contrary to the literature which suggests the existence of a true branchiogenic carcinoma (Spiro et al, 1983;Browder et al, 1984;Shreedhar and Tooley, 1984;Parks and Karmody, 1992;Jacobsen et al, 1998;Redaelli de Zinis et al, 1998). One of these SCC, however, was extremely well differentiated and arose from a background of longstanding chronic inflammation and scarring (Shreedhar and Tooley, 1984), another arose from preauricular ectodermal remnants of the first branchial cleft (Parks and Karmody, 1992). We did not observe mucoepidermoid differentiation or mucus-containing cells, either in our series of benign lateral neck cysts (Regauer et al, 1997) or in this series of cystic carcinomas which contrasts a report of a primary welldifferentiated mucoepidermoid branchiogenic carcinoma (Browder et al, 1984).…”

Section: Discussionmentioning

confidence: 76%

“…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).…”

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confidence: 99%

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

et al. 1999

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Carcinomas of the oro/nasopharynx often present with regional lymph node (LN) metastases before the primary tumour is discovered. 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). 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. At the same time, the idea of a primary branchiogenic carcinoma has become a vanishing concept (Thompson and Heffner, 1998). Despite the body of literature about this topic, there is little information regarding the frequency of cystic LN metastases from SCC of the Waldeyer's ring. Our goal was to establish the frequency of cystic LN metastases in our series of 123 patients with SCC of Waldeyer's ring origin who had been treated primarily surgically along with neck dissections. Furthermore, we discuss the morphological features and clues for establishing a diagnosis of cystic LN metastases rather than 'branchiogenic carcinoma'. 1984 and 1997, 108 patients with biopsy-proven SCC of Waldeyer's ring origin underwent neck dissections at the ORL Department of the University Hospital in Graz, Austria. Fifteen patients were treated at the Elisabethinen Hospital, Graz, Austria, between 1992 and 1997. Archival formalin-fixed, paraffinembedded haematoxylin and eosin (HE) stained sections of all primary SCC and their corresponding neck dissections were reviewed. SCC were separated into (1) tonsillar origin (palatine tonsil), (2) base of tongue origin and (3) nasopharyngeal origin. Extensive tumours involving the entire oropharynx, and multiple or synchronous intraoral carcinomas were not included in this study, because we were not able to determine the exact origin of the SCC in these cases. Initial diagnosis was established by biopsy and fol...

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Section: Discussionmentioning

confidence: 76%

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confidence: 99%

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

et al. 1999

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“…7 Second branchial cleft cysts, as in our case, develop as a result of a congenital anomaly of this structure, or of the endodermal pharyngeal pouch. 4 These branchial cleft cysts present clinically as smooth, soft, ovoid, cystic masses in the lateral part of the neck, behind the angle of the mandible, and anterior to the sternocleidomastoid muscle.…”

Section: Discussionmentioning

confidence: 53%

“…There is a possibility for the development of carcinomatous transformation in the cyst lining. 7 Controversy arises as to the exact origin of these carcinomas. This is because metastatic squamous cell carcinoma is expected to occur with a far great frequency than a primary branchiogenic carcinoma.…”

Section: Discussionmentioning

confidence: 99%

Squamous Cell Carcinoma Arising in a Second Branchial Cleft Cyst

Girvigian

Rechdouni²,

Zeger³

et al. 2004

American Journal of Clinical Oncology

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The existence of primary branchiogenic carcinoma is controversial. In 1950, Martin et al. established four criteria for the diagnosis of primary branchiogenic carcinoma. In 1989, Khafif et al. proposed new criteria, which are currently most recognized in the literature. A pathologic description of the surgical specimen is analyzed and compared with a critical review of the literature. A case is presented in which imaging established the diagnosis of a benign second branchial cleft cyst 2 years prior to the diagnosis of a branchiogenic carcinoma in the same cyst. This cyst was resected and was found to have squamous cell carcinoma arising from the benign epithelium. This case satisfies the histologic criteria established by Martin and Khafif for a primary branchiogenic carcinoma arising in a previously benign second branchial cleft cyst.

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“…5 Histologie comparisons between normal lymph nodes and branchial cleft cysts reveal several shared characteristics, while also illuminating three features that are exclusive to lymph nodes: peripheral lobulation, internodular trabeculae, and perinodal sinuses. 6 Carcinomas metastatic to lymph nodes may show some of these characteristics, thus distinguishing themselves from BCC.…”

Section: Authors Treatment Histology Follow-upmentioning

confidence: 97%

Branchial Cleft Cyst Carcinoma: Myth or Reality?

Singh¹,

Balwally²,

Har‐El³

et al. 1998

Ann Otol Rhinol Laryngol

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Skepticism has surrounded the existence of branchial cleft carcinoma since the entity was first described in 1882. However, a landmark work of 1950 established four criteria for the diagnosis of branchial cleft carcinoma, the most important criterion being histologic proof of carcinoma arising from a normal cyst epithelium. Of the 43 cases found in an extensive review of the literature, only 7 cases have satisfied all four of the criteria. To this we add 2 patients who had recurrent infections of a cervical cyst as children and later developed carcinoma within these structures. Additionally, we propose a minor modification to the 1950 criteria and a paradigm for diagnosis and management of these lesions.

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The First Branchial Cleft Carcinoma

Cited by 31 publications

References 13 publications

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

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

Squamous Cell Carcinoma Arising in a Second Branchial Cleft Cyst

Branchial Cleft Cyst Carcinoma: Myth or Reality?

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