Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Nasopharyngeal Branchial Cleft Cyst in an Elderly Man: An Atypical Presentation

Articles in Press

Document Type : Case Report

Authors
Gautam Bir Singh 1
Priyanka Sharma 1
Kavita Gaur 2
1 Department Otorhinolaryngology- Head & Neck Surgery, ABVIMS & DR. RML Hospital, New Delhi, India.
2 Department of Pathology, Lady Hardinge Medical College & Associated Hospitals, New Delhi, India.
10.22038/ijorl.2026.95727.4153
Abstract
Introduction:
Branchial cleft cysts (BCCs) account for nearly one-third of congenital cervical masses, but their occurrence within the nasopharynx is exceedingly uncommon. Most reported nasopharyngeal cases involve children or young adults; presentation in older patients raises concern for cystic metastasis from an occult head and neck malignancy.

Case Report:
We describe a 64-year-old man with a three-year history of progressive bilateral nasal obstruction and recurrent rhinosinusitis. Endoscopy disclosed a smooth, mobile, midline pinkish nasopharyngeal mass; cross-sectional imaging confirmed a well-defined T2-hyperintense cystic lesion in the upper posterior nasopharynx. Endoscopic transnasal piecemeal excision was performed, and histopathology established a branchial cleft cyst without dysplasia or malignancy. The patient remained asymptomatic on follow-up.

Conclusion:
This case underscores the importance of including nasopharyngeal BCC in the differential diagnosis of cystic nasopharyngeal lesions, even in elderly patients in whom cystic carcinoma metastasis must first be excluded.
Keywords
Branchial cleft cyst
Nasopharynx
Endoscopy, Excision
Congenital cyst
Subjects
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Iranian Journal of Otorhinolaryngology

Articles in Press, Corrected Proof
Available Online from 26 August 2026