Lateral cervical cysts: a review of 42 cases

A review of forty-two patients presenting over a ten year period with a histological diagnosis of lateral cervical (branchial) cyst was undertaken. Most occurred in the second and third decades (29/42), there was a slight female predominance (29/42). Thirty-five lesions presented at the classic site, 7 presented elsewhere in the neck. Ten lesions were painful on presentation, none of these were associated with systemic signs of infection. Preoperative diagnosis was correct in only 22 cases and was more likely to be incorrect when on presentation the lesion was painful, located away from the classic site or was solid to palpation. Incision of painful cysts led to increased patient morbidity. It is suggested that greater awareness of less usual presentations of lateral cervical cysts and use of fine-needle aspiration biopsy would improve diagnostic accuracy and reduce morbidity.