Abstract
INTRODUCTION Brachial cleft cyst is the most common cause of cystic lesion in the neck in younger population. But in
patients above 40 years of age, about 80% of the cystic neck lesions were reported to be malignant. The incidence of such
type of metastasis from Waldeyer's ring accounts for 33-62%. CASE REPORT A 60 year old male presented with a
painless swelling in the left side of the neck for 8 months. Clinical features, imaging and FNAC favoured infected brachial
cyst. Excision biopsy showed metastatic carcinomatous deposits with high mitotic index. Panendoscopy with
tonsillectomy done. Biopsy of left tonsil showed moderately differentiated squamous cell carcinoma. Then adjuvant
Radiotherapy was given to the patient and on 6th month follow up, patient had no features of recurrence.CONCLUSION
For any cystic neck lesion in an adult, metastatic disease must be considered as a differential diagnosis. And for proven
malignant cystic cervical lymph node, a primary malignancy involving Waldeyer's ring should be suspected. Initially
imaging and FNAC may be taken. If FNAC is inconclusive, excision biopsy may be done. Then depending upon the
biopsy finding, pan endoscopy with guided biopsies and tonsillectomy may be done.
Subject
Organizational Behavior and Human Resource Management,Applied Psychology,Ecology, Evolution, Behavior and Systematics,Sociology and Political Science,Philosophy,Religious studies,Education,Library and Information Sciences,Museology,Information Systems,History,Visual Arts and Performing Arts,History and Philosophy of Science,Health Policy,General Medicine,Issues, ethics and legal aspects,General Medicine,Organic Chemistry,Drug Discovery,Pharmacology,Management, Monitoring, Policy and Law,Nature and Landscape Conservation,Ecology,Pharmacology (medical),Drug Discovery,Pharmaceutical Science,Pharmacology