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Case report
Fourth branchial pouch anomaly presenting as a neonatal neck lump
  1. Jacob Reading1,
  2. Robert Nash2 and
  3. Benjamin Hartley2
  1. 1Paediatrics, Buckinghamshire Healthcare NHS Trust, Aylesbury, UK
  2. 2Ear, Nose and Throat Surgery Department, Great Ormond Street Hospital For Children NHS Trust, London, UK
  1. Correspondence to Dr Jacob Reading; jake.reading{at}


A 1-week-old female infant presented with a transilluminating neck lump that increased in size with crying. The presumptive diagnosis was lymphatic malformation, but imaging raised the possibility of an abscess or necrotic tumour. A biopsy revealed a likely developmental cyst with local inflammatory change. Microlaryngoscopy revealed a fourth branchial pouch sinus, which was cauterised. The sinus and neck lump resolved without need for further treatment.

  • ear
  • nose and throat/otolaryngology
  • congenital disorders
  • head and neck surgery
  • otolaryngology / ENT

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  • Contributors JR wrote the paper and performed a search of relevant literature. RN and BH were involved in the management of the patient and reviewed the article prior to submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.