A 30yo man presents with a 5cm neck mass anterior to the sternocleido-mastoid muscle

A 30yo man presents with a 5cm neck mass anterior to the sternocleido-mastoid muscle on the
left side in its upper third. He states that the swelling has been treated with antibiotics for
infection in the past. What’s the most likely cause?
a. Branchial cyst
b. Parotitis
c. Pharyngeal pouch
d. Thyroglossal cyst
e. Thyroid swelling

Q. 1. What is the key?
Q. 2. Justify your answer.

Ans. 1. The key is A. Branchial cyst.
Ans. 2. i) Branchial cyst is anterior triangular lump. [parotid is also anterior triangular lump but parotitis
regresses with appropriate treatment i.e. becomes normal in size]. ii) pharyngeal pouch is posterior
triangular lump. iii) Thyroglossal is midline lump. iv) thyroid swelling moves with swallowing].

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