DOI: https://doi.org/10.36347/sjmcr.2025.v13i11.025

Pages: 2771-2778

Background: Branchial cleft cysts (BCCs) are congenital epithelial cysts resulting from developmental anomalies of the branchial apparatus. Type IV BCCs are extremely rare, especially in children. Case Presentation: We report the case of an 11-year-old male presenting with a right-sided neck swelling for 1.5 years and foreign body sensation in the throat for 1 year. Clinical and radiological evaluation confirmed a large Type IV branchial cleft cyst causing significant airway compression. The cyst was excised via a transcervical approach following elective tracheostomy. Postoperative recovery was uneventful, and histopathology confirmed the diagnosis. Conclusion: Type IV branchial cleft cysts are rare in the pediatric population. Accurate diagnosis through imaging and meticulous surgical excision are essential for optimal outcomes and prevention of recurrence.