Diagnostic approach and surgical management of a complicated branchial cleft cyst in an adult

Cystic neck masses constitute a diverse group of pathological entities that pose diagnostic challenges, particularly in adults where malignant causes must be excluded. Branchial cleft cysts are congenital anomalies that often remain asymptomatic until adulthood, presenting after secondary infection or abscess formation. We report a case of a complicated second branchial cleft cyst in a 38-year-old male presenting with recurrent laterocervical abscess. Diagnosis was established through clinical evaluation, imaging, and histopathological analysis. Initial management involved abscess drainage and exclusion of malignancy, followed by definitive surgical excision after infection resolution. The patient recovered fully without recurrence. This case underscores the importance of a systematic diagnostic approach and timely surgical management to prevent recurrence and complications in adult patients with cystic neck lesions.