First brachial cleft cyst in the parotid area

A first brachial cleft cyst was detected in the parotid area of a 66-year-old Japanese man complaining of swelling in the left upper neck. Although the lesion was suggestive of a cyst, based on computed tomography and magnetic resonance imaging, the lesion was misdiagnosed as a benign tumor, because it was thought to localize to the parotid and most lesions occurring in the parotid gland are tumors. The histopathological diagnosis was a first brachial cleft cyst or a so-called lymphoepithelial cyst. This case demonstrates that it may be difficult to differentiate a cyst from a benign tumor in the parotid area.