Third branchial cleft anomaly presenting as a retropharyngeal abscess

Branchial cleft anomalies are congenital developmental defects that typical ly present as a soft fluctuant mass or fistulous tract along the anterior b order of the sternocleidomastoid muscle. However, branchial anomalies can m anifest atypically, presenting diagnostic and therapeutic challenges. Error or delay in diagnosis can lead to complications, recurrences, and even lif e-threatening emergencies. We describe a case of an infected branchial clef t cyst that progressed to a retropharyngeal abscess in a 5-week-old female patient. The clinical, radiographic, and histologic findings of this rare p resentation of branchial cleft cyst are discussed. (C) 2000 Elsevier Scienc e Ireland Ltd. All rights reserved.