Carcinoma developing in a branchial cyst.

Introduction: The malignant transformation of the branchial cysts epithelium is rare and it represents separate entity called branchiogenic carcinoma.

Case Report: A 55-year-old male with fluctuating mass localized on the right side of the neck, was admitted to the Department of Maxillofacial Surgery, General hospital in Vrbas where cystic tumor 3 cm in its greatest dimension with friable, dark red wall below the front edge of the sternocleidomastoid muscle was revealed. The wall of the tumor was composed of lymphoid tissue with germinal centers. The internal surface of the cyst was lined with thin layered squamous epithelium that showed a transition from the normal, followed by the atypical epithelium, and the in situ carcinoma to the part corresponding to a poor differentiated invasive squamous carcinoma. Following the diagnosis of suspected branchiogenic carcinoma a radical neck dissection was performed. No elements of the tumor had been found in the sampled materials taken from striated muscle tissue, salivary gland tissue and reactive lymph nodes (n = 24). The patient was presented to Oncology Consilium, and radiotherapy was implemented.

Conclusion: The definitive diagnosis must be based on histological features. A five-year monitoring of the patient is necessary to rule out cervical metastasis of this tumor. It is necessary for a five-year follow-up to rule out cervical metastasis of the tumor.