An Autopsy Case of Branchiogenic Carcinoma

Branchiogenic cysts arise from the remnant of the branchial apparatus. It is no doubt that primary carcinoma arising in a branchiogenic cyst does exist as a pathological and clinical entity. A 45-year-old man complained a painless mass in the left lateral neck. There were no other symptoms. Postmortem examination revealed a huge 11 by 10 by 10 cm ulcerated, partly necrotic and hemorrhagic tumor. Microscopic picture exhibited epidermoid carcinoma composed in part of a travecular pattern of large, polyhedral cells with faintly granular and acidophilic cytoplasm. Intercellular bridges were observed but not prominently. Occasionally giant cells, with giant nuclei or multiple nuclei, were seen. Individual cell keratinization was frequent, but keratin pearls were not found. Mitotic figures were numerous. Special stains failed to reveal any cytoplasmic inclusions. There have been only a few cases reported that showed histological evidence of carcinoma arising in a branchiogenic cleft cyst. In this case the author could not demonstrate cancer arising in the wall of a branchiogenic cyst, and no remnant of the branchial apparatus were found. Exhaustive studies failed to demonstrate a primary site for the cancer in other areas. Clinically the tumor was soft and fluctuant, and serous bloody fluid was removed by puncture. These findings suggest the possibility of branchial cyst origin