An unanticipated case report of squamous cell carcinoma arising from a submandibular branchial cleft cyst.

Introduction and importance: Cervical area tumors, especially squamous cell carcinoma (SCC), present important clinical challenges, accounting for almost 90% of all head and neck malignancies. Risk factors such as tobacco use, alcohol consumption, and human papillomavirus infection increases the incidence of these malignancies. While SCCs often arise from primary tumors in the oral cavity or other regions, they can also observe in atypical sites like branchial cleft cysts. Case presentation: This report introduces a rare case of SCC arising from a submandibular branchial cleft cyst in a 60-year-old cigarette smoker and opium addict female patient. The patient displayed a progressive mass with no history of malignancy or other problems in the head and neck region. Clinical discussion: Following surgical resection, histopathological observations confirmed SCC within the branchial cleft cyst, indicating a rare malignant transformation. Notably, the primary source of SCC remains undetermined despite comprehensive evaluations. Conclusion: Although branchial cleft cysts are typically benign, this case underscores the importance of careful assessment of neck masses in patients with risk factors for malignancy, to facilitate early diagnosis and optimal management of this uncommon presentation of SCC.