Branchial cysts-adult presentation

INTRODUCTION There are 5 mesodermal arches separated by invaginations of ectoderm (clefts) and endoderm (pouches). Branchial cysts result from failed obliteration of branchial clefts. Second branchial cleft cyst is the most common type, which is found in about 95% of cases (Panchbhai and Choudhary 2012). Branchial cysts are common in the lateral aspect of the neck. They usually appear as a fluctuant swelling deep to the sternocleidomastoid muscle anteriorly. They are often present in the second and third decade of life. Clinical diagnosis is mandatory. Radiology may also help for proper localization of the cyst. Fine needle aspiration cytology (FNAC) can also facilitate the diagnosis. Excision is the treatment of choice to aid in diagnosis, for cosmetic reasons and to prevent possible infection of the cyst. CASE REPORT A 42 year old female presented with a solitary swelling in the left side of the neck of one and half year duration. Initially the swelling was small in size, and gradually increased with time to attain the present size . There was no pain in the swelling.General and systemic examination revealed no other abnormality. On examination an 8 cm x 6 cm swelling was found in the left anterior triangle of the neck. It extended from