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A 59-year-old woman presented with a 6-month history of a painless sensation of mild airway compression and a right-sided neck mass.
Contrast-enhanced computed tomography demonstrated a well-circumscribed,
right-sided, level IV nonenhancing mass (Figure 1) and a smaller mass abutting the thyroid gland (not shown). A diagnosis of branchial cleft cyst was made, and the patient underwent excision and thyroid biopsy. The pathology report identified a well-differentiated squamous cell carcinoma, and the thyroid specimen was noted to have squamous metaplasia. The patient was subsequently referred for evaluation and definitive management.
Frazier WD, Patel NP, Sullivan CA. Pathology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2008;134(3):333. doi: