Jing Hern KHOO, Faizah Abdul RAHIM, Nik Fatimah Salwati Nik MALEK, Azliana AZIZ
Turkish Archives of Pediatrics - 2026;61(4):363-365
Fourth branchial cleft anomalies are the second most common pediatric congenital lesions of the head and neck. They arise from incomplete obliteration of the branchial arches during embryogenesis, probably due to the asymmetric vascular development of the adjacent arches. Fourth branchial anomalies account for less than 1% of branchial malformations. They typically manifest as recurrent left-sided neck swelling or abscess, leading to diagnostic challenges. We report a diagnostic dilemma involving a fourth branchial cleft cyst, initially misdiagnosed based on imaging.