Bronchogenic cyst presenting as deep neck abscess

Recurrent abscesses deep in the lower neck should be suspected of having a congenital or developmental etiology. The differential diagnosis would include laryngopyocele, branchial cleft cyst, thymic cyst, bronchogenic cyst, esophageal diverticulum, and thyroid cyst. While parenteral antibiotic therapy and incision and drainage of the abscess cavity will provide temporary relief, further diagnostic studies should be performed in an attempt to identify the origin and extent of the disease process. Our patient had four episodes of an abscess forming deep in the lower neck, with a diagnostic workup proving negative before total exicision demonstrated the presence of the bronchogenic cyst. To our knowledge this is only the fourth case in the literature of a bronchogenic cyst presenting in the lower neck.