Heterotopic cervical salivary glands

Area of Science:

• Pediatric Surgery
• Head and Neck Surgery
• Developmental Biology

Background:

• Branchial sinuses are congenital malformations typically presenting as external or internal openings along the anterior border of the sternocleidomastoid muscle.
• Lateral cervical sinuses are a rare variant of branchial anomalies, often presenting in the lower neck region.

Observation:

• A four-year-old girl presented with bilateral symmetrical cutaneous orifices at the junction of the middle and lower thirds of the sternocleidomastoid muscles.
• Preoperative diagnosis suggested lateral cervical or branchial sinuses.
• Surgical exploration revealed sinus tracts extending only 2 cm deep to the skin surface.

Findings:

• Histological examination of the excised tissue demonstrated the presence of mixed salivary glands within the sinus tracts.
• This finding is atypical for classic branchial cleft anomalies.

Implications:

• The case highlights the importance of thorough histological examination for accurate diagnosis of congenital neck anomalies.
• It expands the differential diagnosis for anterior neck cutaneous openings, including salivary gland inclusions.
• Further research into the embryological origin of such salivary gland-lined tracts in the neck is warranted.