RESUMO
BACKGROUND: the amygdaloid cyst is a rare laterocervical cystic tumor arising from the second branchial cleft. It accounts for 2% of laterocervical tumors. AIM: analyze the anatomo-clinical characteristics and discuss the management and therapeutic indications of second branchial cleft cysts. METHODS: we report a 14-year retrospective study (2000-2013) concerning 34 cases of amygdaloid cysts diagnosted and treated at ENT department of Farhat Hached hospital of Sousse. RESULTS: The average age of our patients was 27 years with a sex ratio 0.8. Physical examination found a cervical mass in all the cases: jugulo-carotid in 26 cases (77%), supraclavicular in two cases (6%). The location was not specified in 6 cases (17%). Cervical ultrasound was performed in 30 patients, and showed a cystic mass in 17 cases. Complement by CT was performed in 5 patients suggesting the diagnosis of second branchial cleft cysts in two cases. One patient had an MRI for a large supraclavicular mass. A fine needle aspiration biopsy was performed in 13 patients. All patients underwent surgery with complete excision of the cyst. Histopathological examination confirmed the diagnosis of second branchial cleft cysts, with 2 cases of malignant degeneration. One case of recurrence was noted. CONCLUSIONS: Second branchial cleft cysts are relatively rare malformations. Their diagnosis is confirmed by pathological examination. The treatment is surgical.
Assuntos
Branquioma , Neoplasias de Cabeça e Pescoço , Adolescente , Adulto , Idoso , Branquioma/diagnóstico , Branquioma/patologia , Branquioma/radioterapia , Branquioma/cirurgia , Criança , Pré-Escolar , Estudos de Coortes , Terapia Combinada , Diagnóstico Diferencial , Feminino , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/terapia , Estudos Retrospectivos , Adulto JovemRESUMO
Synovial sarcoma is an uncommon, aggressive malignant tumor of the soft tissues primarily involving the extremities of young adults. Head and neck synovial sarcoma is rare, and its diagnosis and therapy are still challenging.We report a case of a young patient with synovial sarcoma, clinically masquerading as cystic mass of the neck and malignant second branchial cleft cyst. The pathological diagnosis of the sarcoma was confirmed by a multimodality diagnostic protocol, including histological, immunohistochemical and molecular genetic analysis. The patient underwent complete surgical excision followed by postoperative radiotherapy and recovered well.
Assuntos
Branquioma/patologia , Neoplasias de Cabeça e Pescoço/patologia , Pescoço/patologia , Sarcoma Sinovial/patologia , Branquioma/radioterapia , Branquioma/cirurgia , Terapia Combinada , Diagnóstico Diferencial , Neoplasias de Cabeça e Pescoço/radioterapia , Neoplasias de Cabeça e Pescoço/cirurgia , Humanos , Masculino , Pescoço/cirurgia , Sarcoma Sinovial/radioterapia , Sarcoma Sinovial/cirurgia , Resultado do Tratamento , Adulto JovemRESUMO
A case of thyroid papillary carcinoma arising in ectopic thyroid tissue within a branchial cleft cyst is described. Complete dissection of the thyroid gland was necessary to rule out the differential diagnosis of primary thyroid carcinoma. The thyroglossal duct tract is an unusual localization for thyroid carcinomas in ectopic thyroid tissue. Thyroid carcinoma arising in ectopic thyroid tissue within a branchial cyst is extremely rare. Complete thyroidectomy may be necessary to eliminate an occult thyroid carcinoma.
