A Case of A Mammary Analogue Secretory Carcinoma of the Submandibular Gland Mimicking a Second Branchial Cleft Cyst

A mammary analogue secretory carcinoma (MASC) of the submandibular gland is a rare occurrence. In this case report, we describe an 18-year-old girl with a MASC of the submandibular gland, who presented with symptoms of painful swelling of the level II cervical area. Computed tomography (CT) was performed, and fine needle aspiration cytology was suggested to aid in the diagnosis. An initial diagnosis of a second branchial cleft cyst was made, for which antibiotic therapy and excision of the cyst were performed. Further investigation was done after endoscopic excision via the retroauricular approach for cosmesis. Preoperative computed tomography suggested an infected second branchial cleft cyst ; however, the pathology report revealed a MASC of the submandibular gland, which is a rare finding. Although the clinical presentation of the mass was similar to a second brachial cleft cyst, characteristic MASC findings were observed on immunohistochemical examination; a successful endoscopic mass excision was performed. (J Clinical Otolaryngol 2016;27:370-374)