Three kinds of cysts in the same patient
An 18-year-old male presented with a history of asymptomatic swelling (3 × 5 cm) in the lateral region of the neck at the level of the mastoid, that was present since 2 months. It was fluctuant to palpation and freely mobile. A presumptive diagnosis established was of an epidermal cyst (EC); therefore, the lesion was extirpated. The content was caseous white-yellow material. From histopathological findings, it was reported as EC. After surgical intervention a hypertrophic scar developed as a complication.\nAfter 4 years and 10 months, there was a swelling that was increasing in size (4 × 2 cm) at the level of the hyoid bone. On physical exploration, the soft mass was at the level of the hyoid bone, which at the time of deglutition moved to the left side. An axial tomography was taken and a presumptive diagnosis of a TDC was established [Figure and ]. The surgical procedure was carried out 2 months later without apparent complications and the specimen was submitted for histopathological study, the results were in favor of a TDC []. Five days after surgery, the aponeurotic space was swollen and the patient complained of hypoesthesia, the patient presented a sensation of asphyxia that forced him to put the head in hyperextension in order to breath, after 3 days the sensation became worse and there was the need to debride. Draining yielded a thick yellow-liquid similar to lymph. A Penrose was placed and was kept for 4 days, the post operative condition was uneventful.\nAfter 2 months of the TDC surgery, the patient came again with a tumefaction on the right side of the neck close to mandible angle of approximately 3 cm, the presumptive diagnosis was an infected sebaceous cyst and medication was prescribed (10 mg Danzen®, Serratio Peptidase, Laboratory Hormona, Mexico) daily for a week. The cyst was enucleated on the same month without complications. The final histopathological report was of a branchial cyst [].