- to describe the current theories about pathogenesis of congenital cystic masses of the neck. - to identify typical imaging appearances of thyroglossal duct cysts, branchial cleft cysts, and dermoid cysts ⋅ - to understand the importance of neck anatomy in establishing the radiologic diagnosis for these lesions. - to identify some important mimics and their differential diagnoses.

Congenital cervical cysts and fistulas are uncommon malformations. Diagnosis and management of congenital cervical cysts and fistulas requires a good understanding of their embryological development and topography. Thyroglossal duct cysts are most common, followed by branchial cleft anomalies and dermoid cysts. The imaging options and the value of each for particular masses, as well as present clinical and radiologic images for each, are discussed.

DISCUSSION: Introduction Congenital cystic masses of the neck include thyroglossal duct cysts, branchial cleft cysts, cystic hygromas, dermoid cysts and bronchogenic cysts. These lesions vary in prevalence from common (thyroglossal duct cysts, branchial cleft cysts, and cystic hygromas) to very rare (thymic and cervical bronchogenic cysts). The clinical history and physical examination of the patient are the most important factors in the evaluation of a congenital neck mass. An appropriate knowledge of the embryology and anatomy of the cervical region frequently allows the differential diagnosis...

Diagnosis of malformations of the midline is usually straightforward. However, diagnosis of malformation of the laterocervical region can be problematic. Misdiagnosis often leads to inadequate treatment with recurrence and functional as well as cosmetic sequelae. The precise anatomical location and imaging appearances are important for accurate diagnosis and formulating the differential diagnoses of cystic lesions in the neck.

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