Cervical tumor as the only manifestation of pyriform sinus fistula

Lymphadenopathy is the most common benign cervical tumor in children, but other pathologies should be suspected in case of atypical location, rapid growth, tougher consistency, inflammatory signs or spontaneous suppuration. Pyriform sinus fistula is an unusual congenital malformation of the branchial arches. After an infection, it results in a pseudotumoration that usually occurs with local inflammatory signs, fever and odynophagia, so that the treatment of the acute process is broad-spectrum systemic antibiotic therapy sometimes associated with drainage. The study of any cervical mass should begin with an ultrasound, to be completed with a CT scan with contrast in case of suggestive findings of abscess adjacent to the thyroid or inflammation of the thyroid, that can point towards a pyriform sinus fistula. The diagnostic method of choice is the endoscopic examination in the operating room under general anesthesia, that also allows the definitive surgical treatment. We present the clinical case of a patient who comes from Primary Care after detecting an indurated tumor at the left paramedial level as the only manifestation, consequence of a pyriform sinus fistula.