Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-24T08:39:45.676Z Has data issue: false hasContentIssue false
  • English
  • Français

Cervical node metastases presenting with features of branchial cysts

Published online by Cambridge University Press:  29 June 2007

P. M. Flanagan ,
N. J. Roland  and
A. S. Jones
P. M. Flanagan
Affiliation:
Department of Otolaryngology, University of Liverpool.
N. J. Roland
Affiliation:
Department of Otolaryngology, University of Liverpool.
A. S. Jones*
Affiliation:
Department of Otolaryngology, University of Liverpool.
*
Professor A. S. Jones, Department of Otolaryngology, University of Liverpool, Royal Liverpool Hospital, PO Box 147, Liverpool L69 3BX.
Get access Rights & Permissions [Opens in a new window]

Abstract

For many years it has been recognized that seemingly benign neck cysts may contain carcinoma. The true incidence is unknown. This paper investigated nine out of 270 patients presenting with a neck mass — which proved to contain a squamous carcinoma. Records (from a 30-year period) of over 3400 patients with squamous carcinoma of the head and neck, were examined. The histology slides were reviewed, the number of cystic lesions was noted and also the clinical outcome. Out of the 270 patients nine presented with a cystic lesion and these were studied. Six cystic lesions were originally diagnosed as branchial cysts although the youngest age was 39 years. All patients underwent a simple excision.

In six cases the tonsil was the primary site, in one the primary was in the base of tongue and in two the primary remained occult. One-third of the patients had died of their disease by the time this report was written and the maximum follow-up time for the remaining patients was 18 months. Therefore 16 per cent of branchial cysts in this series represented metastases from squamous cell carcinoma.

At the Royal Liverpool University Hospital only 25 patients had branchial cysts excised between 1988 and 1993: out of these only four contained squamous carcinoma.

In patients over 40 years of age panendoscopy and ipsilateral tonsillectomy is mandatory prior to cyst excision.

Keywords

Head and neck neoplasmsCarcinoma, squamous cellNeoplasm metastasisLymph nodeBranchioma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 12 , December 1994 , pp. 1068 - 1071
Copyright
Copyright © JLO (1984) Limited 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bath, A., Murty, G., Bradley, P. J. (1992) Branchial cyst — to endoscope or not? Journal of Laryngology and Otology 106: 1006–1007.CrossRefGoogle ScholarPubMed
Carrick, D., Jones, W., El-Sharkawi, A. (1986) Branchiogenic carcinoma or cystic lymph node metastasis? Journal of Laryngology and Otology 100: 1089–1090.CrossRefGoogle ScholarPubMed
Caslin, A., Roland, N. J., Turnbull, L., Jones, A. S., Smith, P. A. (1994) Immediate reporting of fine needle aspiration cytology of head and neck lesions. Cytopathology (in Press).Google Scholar
Cinberg, J., Silver, C., Molnar, J., Vogl, S. (1982) Cervical cysts: cancer until proven otherwise? Laryngoscope 92: 27–30.CrossRefGoogle ScholarPubMed
Compagno, J., Hyams, V., Safavian, M. (1976) Does branchiogenic carcinoma really exist? Archives of Pathology and Laboratory Medicine 100: 311–314.Google Scholar
Foss, R., Warnock, G., Clark, W., Graham, S., Morton, A., Vunan, E. (1991) Malignant cyst of the lateral aspect of the neck: branchial cleft carcinoma or metastasis? Oral Surgery, Oral Medicine, Oral Pathology 71: 214–217.CrossRefGoogle ScholarPubMed
Gooder, P., Palmer, M. (1984) Cervical lymph node biopsy — a study of its morbidity. Journal of Laryngology and Otology 98: 1031–1040.CrossRefGoogle ScholarPubMed
Granstrom, G., Edstrom, S. (1989) The relationship between cervical cysts and tonsillar carcinoma in adults. Journal of Oral and Maxillofacial Surgery 47: 16–20.CrossRefGoogle ScholarPubMed
Johnson, J., Myers, E., Bedsetti, C., Barnes, L., Schramm, V., Thearle, P. (1985) Cervical lymph node metastases, incidence and implications of extracapsular carcinoma. Archives of Otolaryngology 111: 534–538.CrossRefGoogle ScholarPubMed
Jones, A. S., Cook, J. A., Phillips, D. E., Roland, N. J. (1993) Squamous carcinoma presenting as an enlarged cervical lymph node: the occult primary Cancer 72: 1756–1761.3.0.CO;2-5>CrossRefGoogle Scholar
Krogdahl, A. (1979) Carcinoma occurring in branchial cleft cysts. Acta Otolaryngologia (Stockholm) 88: 289–295.CrossRefGoogle ScholarPubMed
Lindberg, R. (1972) Distribution of Cervical lymph node metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer 29: 1446–1449.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
Loughran, C. (1991) Lymph node metastasis from occult thyroid carcinoma: a sonographic mimic of branchial cleft cyst. Clinical Radiology 43: 213–214.CrossRefGoogle ScholarPubMed
Marlowe, F., Goodman, R., Mobini, J., Dave, U. (1984) Cystic metastases from occult tonsillar primary simulating branchiogenic carcinoma: the case for tonsillectomy as a 'Grand biopsy'. Laryngoscope 94: 833–835.CrossRefGoogle ScholarPubMed
Maran, A. (1987) Scott-Brown's Otolaryngology: vol. 5; Laryngology, (Stell, P. M., ed.), Butterworths, London, pp 288–289.Google Scholar
Maran, A. (1993) Stell and Maran's Head and Neck Surgery, (Maran, A. G. D., Gaze, M., Wilson, J., eds.), Butterworths, London, pp 83–85.Google Scholar
McGuirt, W., McCabe, B. (1978) Significance of node biopsy before definitive treatment of cervical metastatic carcinoma. Laryngoscope 88: 594–597.CrossRefGoogle ScholarPubMed
Micheau, C., Cachin, Y., Caillou, B. (1974) Cystic metastases in the neck revealing occult carcinoma of the tonsil. Cancer 33: 228–238.3.0.CO;2-S>CrossRefGoogle ScholarPubMed
Micheau, C., Kijanienko, J., Luboinski, B., Richard, J. (1990) Socalled branchiogenic carcinoma is actually cystic metastasis in the neck from a tonsillar primary. Laryngoscope 100: 878–883.CrossRefGoogle ScholarPubMed
Robbins, K. T., Cole, R., Marvel, J., Fields, R., Wolf, P., Goepfert, H. (1986) The violated neck: cervical node biopsy prior to definitive treatment. Otolaryngology-Head and Neck Surgery 94: 605–610.CrossRefGoogle ScholarPubMed
Wolff, M., Rankow, R., Fiegel, J. (1979) Branchiogenic carcinoma — fact or fallacy? Journal of Maxillofacial Surgery 7: 41–47.CrossRefGoogle ScholarPubMed