Dermoid cysts of the upper neck and salivary region mimicking second branchial cleft anomalies: A case report

Dermoid cysts, found in the lateral neck are uncommon and it is evident that fewer cases have been documented in the parotid gland and tonsillar fossa area. We would like to report a case of a 20-year-old male patient who has presented with a swelling measuring 7 × 8 cms, on the left side of the upper neck, extending inferiorly from below the pinna and angle of the mandible up to the upper third of the sternocleidomastoid along its anterior border. The patient was provisionally diagnosed with a second branchial cysts and was advised to go for surgical excision. The MRI findings revealed a T1 hyperintense lesion, and a tract that extended to the pharyngeal wall, both of which were missed during the initial evaluation. A lateral presentation in the neck involving the parotid gland is very uncommon, with PubMed and Google searches revealing very few cases.