Carcinoma in situ in a branchial cleft cyst in an adult man

Branchial cleft anomalies may be presented as branchial cysts, fistulas, or sinuses. Our purpose is to describe a very rare case of carcinoma in situ in a branchial cleft cyst (BCC). A 53-years-old man seen in consultation because of latero-cervical tumefaction. Ultrasonography, computed tomography (CT), and fine-needle aspiration cytology (FNAC) were performed. FNAC shows that many cells squamous also with aspects of hyperkeratosis and focal nuclear atypia, hyperchromasia and irregularities membrane. The finding gave evidence of a cyst in the epithelial lining of squamous. The presence of atypia, although focal, recommend surgical complete excision and histological examination. The surgical removal was successful and complete. Microscopically the mass was lined as a cystic formation with severe dysplastic alterations borne by coating epithelium, until carcinoma in-situ images, focally microinvasive. The capsule was intact.