A third branchial pouch cyst presenting as stridor in a child

Area of Science:

• Pediatric Surgery
• Otolaryngology
• Developmental Biology

Background:

• Branchial anomalies are congenital malformations arising from persistent embryonic pharyngeal structures.
• Third and fourth branchial pouch cysts are rare, often presenting in infancy or early childhood.
• Distinguishing between different types of branchial cysts is crucial for appropriate management.

Observation:

• An 18-month-old child presented with stridor and a palpable cystic mass in the lateral neck.
• Imaging and clinical presentation suggested a third branchial pouch cyst.
• Surgical excision was performed for diagnosis and treatment.

Findings:

• The case illustrates a rare presentation of a third branchial pouch cyst.
• Anatomical variations in the course of third vs. fourth branchial cysts were reviewed.
• Histological examination differentiated branchial pouch cysts from branchial cleft cysts.

Implications:

• Accurate diagnosis of branchial anomalies is essential for preventing complications such as infection or airway compromise.
• Understanding the embryological basis aids in differentiating cyst types.
• This case contributes to the literature on rare pediatric cervical masses and branchial system development.