A branchial cyst is a benign developmental anomaly that can form in the neck. It typically troubles patients in their first three decades of life with recurrent episodes of enlargenment. These episodes are often triggered by an upper respiratory tract infections.

Diagnosis of a branchial cyst is made on the history as above and clinical examination which usually reveals the lump in the lateral neck partly hidden under the sternocleidomastoid muscle of the neck. Occasionally with a significant infection the overlying skin can be tender and red/inflammed. Radiology in the form of an Ultrasound and aspiration cytology (cells removed from the lump) are also of real help in the diagnosis.

If symptomatic it is appropriate to remove the gland but this operation is not to be underestimated and should be undertaken by a surgeon competent and who regularly performs a neck disssection. I would always perform a selective neck dissection as it allows me to safely protect the important nerves and large blood vessels (carotid artery and jugular vein) very intimateley associated with the branchial cyst.