A branchial cyst presenting as a fluctuant mass at the anterior border of the sternocleidomastoid muscle at the junction of its upper and middle thirds represents a cyst arising from which pharyngeal cleft remnant?

• A First pharyngeal cleft
• B Third pharyngeal pouch
• C Fourth pharyngeal pouch
• D Second pharyngeal cleft ✓

Explanation

The most common branchial cyst (90% of cases) arises from remnants of the second pharyngeal cleft. It presents as a cystic mass at the anterior border of the upper third of the sternocleidomastoid, typically appearing in the second or third decade. Second cleft cysts contain cholesterol crystals in their fluid. First cleft cysts are near the parotid/EAC; third and fourth pouch anomalies present lower in the neck near the thyroid.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.