Lymph node metastases of squamous cell carcinomas in the neck can appear cystic. Without a clinically apparent primary tumour they can classically be considered to originate in a branchial cleft. We report two cases of cystic squamous cell carcinoma with histopathologic criteria of branchial cleft carcinoma. After a review of the literature, diagnostic strategies, histopathologic features, and therapeutic options for this very controversial clinical situation are discussed. We conclude by suggesting that Martin's criteria, largely used to differentiate between a cystic metastasis of a squamous cell carcinoma and a very theoretical branchial cleft carcinoma should be abandoned for lack of applicability.
"In terms of malignant lesions, squamous cell carcinoma (SCC) of Waldeyer's ring (e.g., palatine and lingual tonsils) and papillary thyroid cancers have a predilection for cystic lymph node metastases   . However, the exact mechanism for the development of cystic lymph node metastases is unclear. "
[Show abstract][Hide abstract] ABSTRACT: We report the case of a 66-year-old man with a cervical neck mass located behind the left sternocleidomastoid muscle. To exclude malignancy, a full workup, including clinical, radiological, and cytological examination, was performed but failed to provide a definitive diagnosis. Histological analysis following excisional biopsy revealed a benign epithelial cyst, consistent with an atypically located branchial cyst. We describe an approach to the management of these neck masses and discuss several theories of the etiology of branchial cysts and how they may come to be abnormally located.
[Show abstract][Hide abstract] ABSTRACT: A case of squamous cell carcinoma of the base of tongue presenting initially as a cystic metastasis in the contralateral neck is described. The patient complained of a painless mass in the left neck, which was removed and histologically diagnosed as cystic malignancy. One year and seven months after the removal, a squamous cell carcinoma of the right tongue base and cystic metastases of the right neck were discovered. The histologic similarity among these three lesions strongly indicated the cystic metastases in the bilateral neck were from the squamous cell carcinoma of the tongue base.
Oral Oncology Extra 02/2006; 42(2):56-59. DOI:10.1016/j.ooe.2005.08.011
[Show abstract][Hide abstract] ABSTRACT: Branchial cleft cysts are among the most common causes for a congenital neck mass. Branchial cleft cyst carcinoma (BCCC) is a type of cancer that arises from cells within these cysts. Despite the distinct criteria that have been reported for its diagnosis, BCCC remains a controversial entity.
We report a case of type I, first BCCC, on a 71-year-old white man. The diagnosis was based on the proposed criteria following lesion history and location, surgical excision, histology, and panendoscopy.
We argue for the first time the hypothesis that congenital branchial cysts and BCCC tumors may result from progenitor cell rests of the embryological branchial development. After a period of dormancy, these cells could eventually awake and proliferate, thus giving rise to branchial cleft cysts. With the acquirement of mutations due to genomic instability, some clones of these cells could transform to malignant stem cells, thus clinically manifesting as BCCC.
The wide recognition of stem cells and their role in carcinogenesis provides a new context for the etiopathogenesis of controversial and rare entities such as the BCCC.
The Journal of craniofacial surgery 05/2011; 22(3):918-21. DOI:10.1097/SCS.0b013e31820fe217 · 0.68 Impact Factor
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