Clinical and Medical Case Reports

Second branchial cleft cysts are congenital anomalies that occur due to failed obliteration of the second branchial cleft during embryogenesis. Whilst location of these anomalies commonly lies between the palatine tonsil and anterior border of sternocleidomastoid, atypical presentations are described in the literature and may prove to be a diagnostic and management challenge. We present a case of a 38-year-old gentleman who underwent multiple drainages and excisions of a recurrent retropharyngeal collection with a histological diagnosis of second branchial cleft cyst. This report documents the diffi culty in clearance of a recurrent branchial cleft cyst in the retropharyngeal space and highlights the importance of suitable surgical access to prevent recurrence.