Fourth branchial pouch anomaly presenting as a neonatal neck lump

A 1-week-old female infant presented with a transilluminating neck lump that increased in size with crying. The presumptive diagnosis was lymphatic malformation, but imaging raised the possibility of an abscess or necrotic tumour. A biopsy revealed a likely developmental cyst with local inflammatory change. Microlaryngoscopy revealed a fourth branchial pouch sinus, which was cauterised. The sinus and neck lump resolved without need for further treatment.

The Role of the Connective Reaction in the Development of Experimental Transplantable Tumours

The development and invasive growth of Guérin T8 epithelioma were studied, from the 1st to the 30th day after transplantation. Our histological observations may be interpreted as follows: 1) the onset of tumour growth is dependent upon the ability of the tumour graft to evoke a continuous vascular proliferation; 2) the undifferentiated connective tissue, which develops around the tumour graft, represents a mechanical support and/or a suitable chemical environment for the vascular proliferation rather than for the malignant invasive growth; 3) the tumour growth will start only when the vascular proliferation reaches the border of the tumour graft and stimulates groups of viable tumour cells, dormant survivors of the largely necrotic tumour graft, to cell division and infiltration.