Branchiogenic carcinoma -- fact or fallacy?

The ongoing debate concerning the existence of malignant transformation of branchial cleft cysts has been analyzed, with the aid of previous reports and reviews in the literature. Six new cases are presented and illustrated. These occurred in 4 male and 2 female patients, having an average age of 60 years. Two of the lesions were within the parotid salivary gland. The longest period of survival was 3 1/2 years. New criteria for the acceptability of tumors as primary branchiogenic cancers are proposed. We believe that, using these strict criteria, rare examples of primary branchiogenic carcinomas do exist; their treatment should include whide local excision, followed by ipsilateral radical neck dissection.