Branchial cysts, also known as lymphoepithelial cysts, may be remnants of an embryonic branchial arch or a salivary gland inclusion in a cervical lymph node. They are distinguished from thyroglossal duct cysts by their lateral location, the absence of thyroid tissue, and their abundant lymphoid tissue. Occult thyroid carcinoma, often a papillary carcinoma, may manifest as a metastasis to a node in the neck, but the microscopic pattern is that of a carcinoma. About 5% of squamous cell carcinomas of the head and neck initially manifest as a nodal metastasis, without an obvious primary site. This patient is quite young for such an event, however. Mucoceles form in minor salivary glands; mucoepidermoid tumors form in salivary glands. The nodule in this patient is in the neck. Paragangliomas are solid tumors that may arise deep in the region of the carotid body near the common carotid bifurcation.