Second Branchial Cyst vs. Mixed Pleomorphic Adenoma

Left picture: The diagnosis is a second branchial cyst (lateral cyst of the neck). Right picture: Analogous to the contralateral picture, this pathology might be a lateral cyst of the neck, too. However, the firm consistence speaks against such a diagnosis. Considering the site, a neoplastic lymphoma or a chronic lymphadenitis might be possible. In fact, surgery and histology revealed a mixed pleomorphic adenoma, being analogous to the mixed type of tumor of the salivary glands. This rare diagnosis emphasizes the significance of excision for differential-diagnostic reasons.

A large mass is visible on the lateral left or right side of the neck in both schoolchildren. Left picture: This pathology lies in the lower half of the neck on the left side. Right picture: Here, the mass lies on the right side in the upper half of the neck below the angle of the jaw. Left picture: The local finding is cystic and tight on palpation. Right picture: This mass is firm.