A 30-year-old male presents with a painless, soft, fluctuant neck swelling at the anterior border of the sternocleidomastoid at its junction with the upper third. The swelling transilluminates and has been present since childhood. The most likely diagnosis is:
- A Reactive cervical lymphadenopathy
- B Thyroglossal cyst
- C Second branchial cleft cyst ✓
- D Cystic hygroma
Correct answer: C. Second branchial cleft cyst
Explanation
A painless, fluctuant, soft swelling at the anterior border of the SCM at the junction of upper and middle third in a young adult is the classical presentation of a second branchial cleft cyst. It is the most common branchial anomaly. Its sinus, if present, opens at the same location, and the tract passes between the internal and external carotid arteries. Thyroglossal cyst is midline and moves on protrusion of tongue. Cystic hygroma is usually in the posterior triangle and presents in infancy.
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.