Pharyngeal cleft sinuses and cysts, and other benign neck lesions

Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Findings of Post Traumatic Lymphangioma in a Young Adult Male

The authors report the case of a 34-year-old male, who underwent a fluorine-18 fluoro deoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) scan 7 years after trauma for the evaluation of multifocal masses in the right iliac and right inguinal areas. CT findings showed multifocal low density masses and ¹⁸F-FDG PET revealed slightly increased uptake (maximum standardized uptake value [SUVmax] 3.1). These findings did not exclude the possibility of a benign or malignant lesion. To achieve differential diagnosis, partial surgical excision was performed and a pathologic examination subsequently revealed lymphangioma. Here, the authors describe the ¹⁸F-FDG PET/CT findings of a rare case of lymphangioma resulting from trauma.

Cystic lymphangioma in adults: can trauma be the trigger?

Cystic lymphangioma is a rare congenital anomaly of the lymphatic system. Most lesions present in infancy or early childhood with a swelling in the head and neck region. We report the case of a lady who presented with a cystic swelling in the suprascapular region that appeared after a fall on outstretched hands. Repeated aspiration and depomedrone injection failed to prevent recurrence. Surgical excision achieved complete removal, and histology showed the lesion as cystic lymphangioma, a rare condition to appear on the shoulder in an adult after trauma.

Branchial cleft or cervical lymphoepithelial cysts: etiology and management

BACKGROUND

The cervical lymphoepithelial or branchial cleft cyst is a developmental cyst that has a disputed pathogenesis. The objective of this article is to provide a brief review of the literature and to define diagnostic terms related to this anomaly, as well as to describe its etiology, clinical presentation and treatment.

CASE DESCRIPTION

The cervical lymphoepithelial or branchial cleft cyst usually presents as a unilateral, soft-tissue fluctuant swelling that typically appears in the lateral aspect of the neck, anterior to the sternocleidomastoid muscle, and becomes clinically evident late in childhood or in early adulthood. Clinicians can diagnose the cyst with appropriate imaging to assess the extent of the lesion before definitive surgical treatment. The authors describe a patient who underwent excision of a well-encapsulated cystic structure that was diagnosed as a branchial cleft cyst.

CLINICAL IMPLICATIONS

The cervical lymphoepithelial or branchial cleft cyst can be easily misdiagnosed as a parotid swelling or odontogenic infection. It is imperative that clinicians make an accurate diagnosis so that appropriate treatment (that is, surgical excision) can be performed. If the cysts are treated properly, recurrences are rare.

Cystic hygroma of the gluteal region

Cystic hygromas occur most commonly in the neck. Rarely are they known to involve the axilla, groin, mediastinum, retroperitoneum, pelvis, mesentery, omentum and spleen. We successfully managed a case of cystic hygroma of gluteal region in a one and half year old child who presented with a cystic, non transilluminant swelling in this region since birth. The diagnosis of cystic hygroma was made by surgery and subsequently confirmed after histopathological examination. Because of rarity of cystic hygroma in gluteal region this case in being reported.