Batool Alsadat Sajadi Nejad - Assistant Professor, Department of Ear, Nose, and Throat surgery, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran
Mahmoud Ganjifard - Assistant Professor, Department of Anesthesiology, Faculty of Medicine, Birjand University of Medical Sciences, Birjand, Iran

Branchial cleft cyst abnormalities account for approximately ۲۰% of congenital neck and head abnormality. There are four types of branchial cleft cyst. The incidence of type one is ۸ percent, type two ۹۵%, type three ۲% and type four ۱ to ۴ percent with just ۱۰۰ reported cases. Type four is reported very rarely in previous investigations and the patient in this survey appears to belong to this type. Also one of the differential diagnoses of the thoracic inlet masses can be considered the branchial cyst Type  IV, which can occur in the fifth decade without any presentation according to our experience in this case in spite of the fact that previous studies which revealed its incidence in the second  to fourth decade of life. Branchial cleft cysts are diagnosed according to MRI and CT scans that in this case the diagnosis is based on a CT scan. The choice treatment for branchial cleft is surgery. Relapse is scarce and imply that a piece of tract’s epithelial lining has remained and it is more common in the patients who suffered from infectious lesion.

Branchial Cyst, Branchial Arch, Branchial Cleft