Branchial Cleft Cyst Carcinoma Remains Grossly Over Diagnosed: A Large Database Analysis

Area of Science:

• Oncology
• Head and Neck Surgery
• Pathology

Background:

• Branchial cleft cyst carcinomas (BCCC) are rare lateral neck malignancies.
• Primary BCCC diagnosis requires excluding cystic nodal metastasis.
• This study investigates BCCC diagnosis using a large database.

Purpose of the Study:

• To characterize the diagnosis of BCCC.
• To analyze patient demographics, treatments, and outcomes.
• To evaluate the accuracy of the BCCC diagnostic code.

Main Methods:

• Retrospective cohort study using the TriNetX Research database (2008-2018).
• Included patients aged ≥18 with ICD-10 C10.4 diagnosis.
• Analyzed demographics, oncologic history, diagnostic rates, and 5-year survival.

Main Results:

• 1070 BCCC patients identified; mean age 59.6, majority male and white.
• BCCC incidence rose until 2015, then dropped.
• 94.4% had another head and neck cancer (HNC) diagnosis within 5 years; 5-year survival was 56.0%.

Conclusions:

• The majority of BCCC patients were likely misdiagnosed with another HNC.
• Poor survival may result from delayed treatment due to misdiagnosis.
• The BCCC diagnostic code is considered detrimental and should be discontinued.