Branchiogenic carcinoma or primary cervical neoplastic cysts are of interest from an historical viewpoint [69, 96]. Few of the purported examples of this entity fulfil the four criteria that Martin et al. considered necessary to establish the diagnosis, which are as follows:
1. The cervical tumour occurs along the line extending from a point just anterior to the tragus, along the anterior border of the sternocleidomastoid muscle, to the clavicle;
2. The histologic appearance must be consistent with an origin from tissue known to be present in the branchial vestigial;
3. No primary source of the carcinoma should be discovered during follow-up for at least 5 years;
4. Cancer arising in the wall of an epithelium-lined cyst situated in the lateral aspect of the neck can be demonstrated histologically (Fig. 9.5) .
The fulfilment of these criteria is practically impossible, and the existence of "branchiogenic carcinoma" must remain entirely hypothetical [69, 73, 96, 116]. The criteria have been criticised on the grounds that they are much too restrictive and nearly preclude a diagnosis of branchiogenic carcinoma [15, 86].
Several authors have estimated that, even accepting tentative examples of branchiogenic carcinoma, its incidence would be minuscule (0.3% of all malignant su-
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