ISPUB.COM The Internet Journal of Otorhinolaryngology Volume 15 Number 1 1 of 4 Branchial Cyst In The Midline Of The Neck: A First Case Report In The Literature S Aggarwal, P Garg, S Bhoriwal, V S Rathee, S Verma, S Mittal, A Narang, K Kaushik, J Singh Citation S Aggarwal, P Garg, S Bhoriwal, V S Rathee, S Verma, S Mittal, A Narang, K Kaushik, J Singh. Branchial Cyst In The Midline Of The Neck: A First Case Report In The Literature. The Internet Journal of Otorhinolaryngology. 2013 Volume 15 Number 1. Abstract Branchial cysts are the commonest cystic swelling of the neck, known to occur usually in the lateral side of the neck mostly in relation with the sternocleidomastoid muscle. It is also described at various other non-classical sites but the literature is silent about its presence in the midline of the neck. The following case describes the location in the midline of the neck hence enriching the literature. INTRODUCTION Branchial cysts are the commonest cystic swelling of the neck, known to occur usually in the lateral side of the neck mostly in relation with the sternocleidomastoid muscle. It is also described at various other non-classical sites but the literature is silent about its presence in the midline of the neck. The following case describes the location in the midline of the neck hence enriching the literature. CASE PRESENTATION: A 35 year old female presented with a gradually progressive painless swelling in the midline of the neck for the past 4 years. It was not associated with any other relevant symptom. Her general physical examination was essentially normal. On local examination, a non-tender and non- transilluminant, cystic swelling, 3x4 cm in size present in the midline of the neck just below the hyoid bone. It was not moving with deglutination and protrusion of the tongue. No other swelling was present in any other region. She was worked up for excisional biopsy under general anesthesia. Intraoperative finding were suggestive of a cystic swelling of size 3.5 x 3.5 cm was present about 2.5 cm above the sternal notch without connective stalk. It also adhered with the strap muscles and pre tracheal fascia, however, it was free from the trachea. It contained milky white material. Histopathological examination revealed it to be a branchial cyst with marked congestion and fibrosis. The patient was discharged on the 2nd postoperative day and is doing well in the follow up. Figure 1 Pre operative photo of patient showing midline swelling