Bilateral branchial cleft cysts with primary papillary thyroid carcinoma concealed within left branchial cleft cyst: An unusual presentation

• Author Details:   
• Neelam Sood ^*
• Ruhi

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Branchial cleft cysts are lateral cystic neck lesions, usually presenting in 2nd to 4th decade of life, due to incomplete obliteration of the branchial apparatus. Bilateral presentation is an infrequent occurrence. Sometimes they may harbour normal thyroid tissue but rarely present with primary papillary thyroid carcinoma without thyroid gland involvement.

We report a case of 23-year-old female presenting with gradually increasing bilateral painless neck swellings. Radiological examination suggested plunging ranula in bilateral sublingual space abutting each other in the midline with enhancing irregular soft tissue density in the left ranula suggesting papillary neoplasm. The thyroid gland was normal in size, shape and signal intensity. FNAC was suggestive of a bilateral cystic lesion with intracystic papillary neoplasm on the left side. HPE confirmed a bilateral BCC with primary left intracystic papillary carcinoma thyroid with extra cystic tumour deposits.

This case report highlights the importance of clinical, radiological, FNAC, and HPE for correct diagnosis and further management.

Keywords: Lateral neck lesion, Branchial cleft cyst, Papillary carcinoma of the thyroid.