Question

A newborn boy had a soft, fluctuant, lobulated mass on the posterior part of the neck, extending into the axilla. The clinical diagnosis is

• A. Spring water cyst
• B. Myelocele
• C. Cystic Hygroma
• D. Bronchial cyst

Hint:

Think of a congenital lymphatic swelling that lights up on transillumination and favours the posterior triangle of the neck.

Answer 1

The Correct Option is C

Step 1: Understanding the Question:
A newborn boy presents with a soft, fluctuant, lobulated swelling in the posterior neck that extends into the axilla, and the question asks for the most likely clinical diagnosis.

Step 2: Key Concept or Approach:
This description is classic for a congenital lymphatic malformation arising from sequestered lymphatic sacs that fail to connect properly with the venous system during development. Such lesions are soft, compressible, brightly transilluminant, and multiloculated, and they characteristically occur in the posterior triangle of the neck with a tendency to track along fascial planes into the axilla.

Step 3: Working Through the Options:
A spring water cyst is simply another name for the same lymphatic malformation, but it is not the preferred clinical term used to describe this presentation. Myelocele is a neural tube defect presenting as an open spinal lesion with exposed neural tissue, not a soft neck swelling. A bronchial cyst arises from remnants of the branchial apparatus and typically presents along the anterior border of the sternocleidomastoid, not the posterior neck extending to the axilla. Cystic hygroma is the standard clinical name for this lymphatic malformation and matches the soft, fluctuant, lobulated, posterior neck-to-axilla description exactly.

Step 4: Conclusion:
The correct answer is Cystic Hygroma.