CONGENITAL NECK MASSES - EMBRYOLOGY AND P ATHOLOGICAL ANATOMY - A RETROSPECTIVE IMAGING MULTICENTER STUDY

Various congenital cervical anomalies are found in the neck region inc luding defects of the branchial apparatus (branchial, thymic and parat hyroid anomalies) and vascular anomalies. They manifest as cystic mass es, sinuses, fistulas and as ectopic glands. This multimulticentric re trospective imaging study done in 5 different radiological centers (4 adult radiological departments and 1 pediatric radiological department ) shows the result in understanding the congenital cervical anomalies and include 63 patients. The age of the patients varied between 24 day s - 81 years with a mean age of 23 years. This study included 27 patie nts having congenital branchial pouch anomalies (4 cases of anomalies of obliteration of the 4 th arch), 14 cases of cervical cystic hygroma s, 11 thyroglossal tract cyst cases, 1 congenital laryngocele case, 1 case of jugular ectasia, 3 cases of capillary haemangioma. The embryol ogic basis of these different malformations were reviewed. Their chara cteristic findings and sites were illustrated together with their typi cal et atypical appearances. The frequency of occurence of each branch ial anomaly were plotted, the second branchial cleft cyst being by far the most common congenital cystic neck mass (70%). The study revealed the role of different imaging modalities in the diagnosis of various congenital cervical anomalies, especially in some particular complicat ed cases of congenital neck masses presenting in adult. Imaging study helps the clinician to anticipate any difficulties in unforeseen circu mstances that may arise including infection haemorrhage, or parapharyn geal extension. Understanding the various radiologic appearances of th ese anomalies is greatly aided by familiarity with their embryologic o rigin. Moreover, considering the anatomic location and radiologic appe arence, the precise embryologic origin can be accurately predicted.