Cutaneous cartilaginous rest in Child
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Synopsis
Congenital cartilaginous rest of the neck (CCRN), also known variously as wattle, cervical auricle, persistent branchial cartilage, and cervical tab, is a rare congenital neck mass thought to represent abnormal development of the embryonic branchial apparatus. CCRNs present at birth as asymptomatic skin-colored subcutaneous nodules or soft pedunculated nodules, typically located on the lower third of the neck overlying the anterior border of the sternocleidomastoid muscle. While CCRNs are likely the result of abnormal branchial migration, there are no reports of associated regional or systemic anomalies. Affected children are otherwise healthy. CCRNs are present at birth and do not enlarge; there have been no cases of malignant degeneration of CCRNs.
Codes
ICD10CM:
Q18.2 – Other branchial cleft malformations
SNOMEDCT:
80817007 – Cartilaginous rest
Q18.2 – Other branchial cleft malformations
SNOMEDCT:
80817007 – Cartilaginous rest
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Thyroglossal duct cyst – Midline cystic lesion, often near the hyoid bone, often with a draining sinus.
- Branchial cleft cysts or sinus tend to occur in the upper third of the neck and are rarely congenital. On palpation, they lack the springy, cartilaginous feel of the CCRN. While frequently congenital, the branchial sinus is fistulous, which distinguishes it from CCRN.
- Pilomatricoma (calcifying epithelioma of Malherbe)
- Pseudotumor of infancy – A firm, fusiform mass located within the body of the sternocleidomastoid muscle that appears within 2-3 weeks of age and grows progressively over the next several months.
- Midline cervical cleft – These present as midline neck linear lesions found almost exclusively in young White females.
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Last Updated:12/15/2021
Cutaneous cartilaginous rest in Child