A few days later, he returned to the surgery, where the “harmless” cysts were upgraded to a branchial cleft cyst – a type of neck lump – and he was referred to OSD Healthcare, Hemel Hempstead.

Discussion The general location of the congenital fistula in our patient was similar to that of a second branchial fistula. Pathological examination revealed that the luminal side of the fistulous ...