Branchial Cleft Cyst Associated with Xanthogranulomatous Inflammation – An Unusual Case

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 2(nd) 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 4(th) 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.