Rationale:
Branchial cleft cysts are benign lesions that result from developmental defects arising from primitive branchial arches, cleft, and pouches. Xanthogranulomatous inflammation (XGI) is a mass forming lesion and its association with branchial cleft cyst is rare.
Patient concerns:
A 23-year-old male presented with a soft, partially mobile, nontender swelling on the left side of submandibular area. His main concern was removal of pathology.
Diagnosis:
Computed tomography scan showed a well-circumscribed rounded cystic lesion suggestive of 2nd branchial cleft cyst, which was histopathologically confirmed as branchial cleft cyst with XGI.
Treatment:
Complete surgical excision was done under general anaesthesia and the lesion was removed in toto.
Outcomes:
Patient's postoperative course was uneventful and he was discharged from the hospital on the 4th postoperative day.
Take-away lessons:
Diagnosis of branchial anomalies should always be considered while dealing with lateral neck swellings and XGI associated with branchial cleft cyst should be carefully investigated and treated.