Enigma in the diagnosis of congenital neck masses: a prospective study


  • Rajesh Radhakrishna Havaldar Senior Resident, J.N.Medical College, KAHER, Belagavi, Karnataka - 590010
  • Anju Singh
  • Priti S. Hajare Professor, J.N.Medical College, KAHER, Belagavi, Karnataka, India - 590010
  • Shama A. Bellad Assistant Professor, J.N.Medical College, KAHER, Belagavi, Karnataka, India - 590010
  • R. S. Mudhol Professor & Vice Principal J.N.Medical College, KAHER, Belagavi, Karnataka, India - 590010




Branchial cyst, Bronchogenic cyst, Congenital neck mass, Dermoid cyst, Thyroglossal cyst


Background: Head and neck swellings are common in routine otorhinolaryngologic practice. This study was done to assess the incidence and varied presentation of different congenital neck swellings.

Methods: Hospital based prospective study done in the Department of Otorhinolaryngology at a tertiary care hospital from January 2017 to December 2018. A total of 28 patients with slow, progressive neck swellings were selected after excluding thyroid swellings and acute inflammatory neck swellings. All patients had no other complaints. After a thorough clinical examination and investigations like ultrasonography, fine needle aspiration cytology and radiological examination, surgery was done, and specimens obtained were sent for histopathological examination. Patients were followed up to 1 year.  

Results: 28 patients with congenital neck mass were studied. 15 were thyroglossal cysts, 7 were branchial anomalies, 5 were dermoid cysts and 1 was bronchogenic cyst. The most frequent congenital neck mass was thyroglossal duct cyst and fistula (53.57%) followed by, in descending order, cysts and fistulas of the branchial apparatus (25%), dermoid cysts (17.85%) and bronchogenic cyst (3.5%) respectively.

Conclusions: The overall presentation in terms of age group, location, incidence and clinical features of congenital neck swellings is an enigma to the treating surgeon as well as the pathologist. The prevalence varies largely among centres. A knowledge of the varied differential diagnosis of slow progressive masses in the neck should be kept in mind while planning the surgical procedure for total removal of the lesion to avoid recurrence.

Author Biography

Rajesh Radhakrishna Havaldar, Senior Resident, J.N.Medical College, KAHER, Belagavi, Karnataka - 590010

Senior Resident, Department of ENT & Head and Neck Surgery, J.N.Medical College, KAHER, Belagavi


Huq MM, Ali MI, Huque SN, Alam KN, Sattar MA, Tarafder KH. Evaluation of neck swelling by cytological and histopathological examination. Bangladesh J Otorhinolaryngol. 2012;18(1):23-9.

Pincus RL. Congenital neck masses and cysts. In: Bailey BJ, Calhoun KH, eds. Head and Neck Surgery: Otolaryngology. 3rd ed. New York: Lippincott-Raven; 2001: 931-934.

Al-Khateeb TH, Al Zoubi F. Congenital neck masses: a descriptive retrospective study of 252 cases. J Oral Maxillofacial Surg. 2007;65(11):2242-7.

Gawai SA, Kumar KR, Sangole VS, Rao SP, George DA, Tiwari R, et al. Complete congenital third branchial fistula: a rare case report. Int J Otorhinolaryngol Clin. 2011;3(2):105-9.

Pryor SG, Lewis JE, Weaver AL, Orvidas LJ. Pediatric dermoid cysts of the head and neck. Otolaryngol-Head Neck Surg. 2005;132(6):938-42.

Ayugi JW, Ogeng’o JA, Macharia IM. Pattern of congenital neck masses in a Kenyan paediatric population. Int J Pediatr Otorhinolaryngol. 2010;74(1):64-6.

Siddique MA, Hossen M, Taous A, Salam KS, Siddiquee BH, Tarafder KH. Clinical presentation of congenital neck mass in children. Bangladesh J Otorhinolaryngol. 2012;18(1):16-22.

Al-Salem AH, Quasaruddin S, Ahmed M. Thyroglossal cyst: a clinicopathological study. Saudi Med J. 1996;17(5):620-5.

Siddique MA, Hossan M, Taour A. clinical presentation of congenital neck masses in children. Bangladesh J Otorhinolaryngol. 2012;18(1):16-22.

Acierno SP, Waldhausen JH. Congenital cervical cysts, sinuses and fistulae. Otolaryngol Clin North Am. 2007;40(1):161-76.

Lin ST, Tseng FY, Hsu CJ, Yeh TH, Chen YS. Thyroglossal duct cyst: a comparison between children and adults. Am J Otolaryngol. 2008;29(2):83-7.

Moorthy SN, Arcot R. Thyroglossal duct cyst-more than just an embryological remnant. Ind J Surg. 2011;73(1):28-31.

Shimazu R, Kuratomi Y, Inokuchi A. A case of an upper cervical bronchogenic cyst in an adult. Auris Nasus Larynx. 2006;33(3):351-3.

Niño-Hernández LM, Arteta-Acosta C, Redondo-De Oro K, Alcalá-Cerra L, Redondo-Bermúdez C, Marrugo-Grace O. Cervical bronchogenic cyst mimicking thyroglossal cyst. Case report and literature review. Cirugia Y Cirujanos. 2011;79(4):356-60.






Original Research Articles