The Controversy of Branchiogenic Carcinoma

Abstract

• Malignant transformation in a cyst of branchial cleft origin is recognized as being a rare and controversial entity. It is an unusual lesion, in that the diagnosis must be made by exclusion following certain well-established criteria used by Hayes Martin and co-workers in 1950. The controversy in regard to the existence of this neoplasm is complicated by the fact that it is located in the same anatomic region as metastatic cervical lymph nodes, thus confusing the clinical and pathologic diagnosis. A patient was seen who satisfied all criteria for the rare diagnosis of branchiogenic carcinoma. The literature and case reports since the extensive review of this topic in 1950 by Martin and co-workers are analyzed. On the basis of our report and the other literature, our conclusion is that this rare lesion of branchiogenic carcinoma definitely exists but that it must be carefully differentiated from other more common lesions. Our suggested plan of management in suspected cases would be wide surgical excision of the cyst, ipsilateral radical neck dissection, and a continuing search for a possible unknown primary tumor with origins elsewhere. Radiation therapy would be reserved for recurrences or discovery of a primary lesion. (Arch Otolaryngol 1981;107:570-572)