The most common location for a second branchial cleft cyst is in the lateral neck, typically along the anterior border of the sternocleidomastoid muscle (SCM), often at the junction of its upper and middle thirds. It may extend deep to the muscle or into the parapharyngeal space. Midline cysts are usually thyroglossal duct cysts. Posterior triangle masses could be cystic hygromas or lymphadenopathy.
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