Volume 1 • Issue 2 • 1000108 Thyroid Disorders Ther ISSN: 2167-7948 JTDT, an open access journal Research Article Open Access Ciuni et al., Thyroid Disorders Ther 2012, 1:2 http://dx.doi.org/10.4172/2167-7948.1000108 Case Report Open Access Thyroid Disorders & Therapy Cysts of the Second Branchial Cleft: Case Report and Surgical Notes R.Ciuni 1 , M.Figuera 2 , C. Spataro 1 , S. Nicosia 1 , A.Biondi 1 , F.Basile 1 and S.Ciuni 1 1 Department of General Surgery, Az-Osp Policlinico –Vittorio Emanuele, University Of Catania, Italy 2 Department of Radiolgy, Az-Osp: Policlinico –Vittorio Emanuele, Italy *Corresponding author: Ciuni Roberto, Department of General Surgery, Az-Osp Policlinico,Vittorio Emanuele, University of Catania, Italy, E-mail: Ciuni.r@gmail.com Received February 07, 2012; Accepted April 21, 2012; Published April 23, 2012 Citation: Ciuni R, Figuera M, Spataro C, Nicosia S, Biondi A, et al. (2012) Cysts of the Second Branchial Cleft: Case Report and Surgical Notes. Thyroid Disorders Ther 1:108. doi:10.4172/2167-7948.1000108 Copyright: © 2012 Ciuni R, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Keywords: Second branchial clet cyst; Diagnosis; Treatment; Surgical notes Clinical Case A 35 year old man presented to clinical observation ater onset of a sudden swelling of let second lateral cervical level. Shortly, this lesion reached a size of 14 x 7 cm (Figure 1). he volume increase was accompanied by an inlammatory reaction that at the time of clinical observation was not present. he patient never presented any general symptoms. Clinically, the lesion presented with smooth margins, well-deined limits, tense-elastic, non-tender upon palpation nor spontaneously, moving on planes both above and below. he ultrasound diagnosed a cystic lesion with peripheral vascularity with some intracystic septums at the inferior pole, as well as intimate relationship with the carotid, he MRI and CT scan show a novel morphology expansive lesion of 48 x 38 x 54 (Figure 2, Figure 3), situated along the anterior margin of the sternocleidomastoid muscle, which is marked, the upper pole joins with the horizontal ramus of the mandibular angle which also comes in contact with the lower pole of the parotid gland, the subman dibular glandis anterior-medially displaced. Its till has a thin fat plane of cleavage that displaces the carotidspa cemedially, the tumor appears with polycyclicmargins, multi-lobulated for the presence of multiple cystic which are marked lyhyper intense on T2contents as luid, with thin walls, with thin septa and context mild impregnation in the contrast phase. here is also a solid nodule about 2 cm in the lower third which in stead presents signiicant enhancement post-contrast that is likely attribute a bletoa vascular component. About the nature of the lesion it’s compatible with lymphangio main the irst case, but it’s in the diferential diagnosis with branchial clet cysts. Ater what was found from the imaging studies, a surgical removal of the lesion was suggested. During surgery (Figure 4) the mass appeared to be composed of a thick wall, multi-lobulated, and illed with purulent liquid (Figure 5). Treatment of branchial cysts is surgical removal. he incision is slightly concave, or horizontal for aesthetic reasons. When we prepare the top lap, the incision of the Abstract Branchial cysts are the most frequent both congenital abnormalities and cysts in the neck. We present the case of an adult man who come to the clinical observation after the sudden onset of swelling of 14 cm at the II LEVEL A, without general symptoms. Clinically, the lesion presented with smooth margins, well-deined limits, tense-elastic, non-tender upon palpation nor spontaneously, moving on planes both above and below. The U. S. CT and MR study conirmed the cystic nature of the lesion (may be a lymphangioma). After its removal histological examination diagnosed an infection of the branchialarch cysts Figure 1: Clinical observation after onset of a sudden swelling of left second lateral cervical level. Figure 2: ( TC-image). Figure 3: ( RM, T2W/TSE ).