[Lateral cervical cysts as primary manifestation of tonsillar cancer]

Of 59 patients with tonsillar carcinoma, eight presented with a cervical cyst which was judged to be a branchial cyst clinically and after fine needle aspiration. In all cases, the cyst was removed and microscopic examination revealed malignancy. The correct diagnosis, carcinoma of the tonsil with cystic lymph node metastasis, was revealed during the primary operation in two cases, in four cases the diagnosis was made at a second operation where ipsilateral tonsillectomy was performed and in two cases the diagnosis was first made several years later. It is concluded that, in patients who are over the age of 40 years, the diagnosis of branchial cyst should not be accepted primarily even if fine needle aspiration does not give any suspicion of malignancy.