Branchial cleft carcinoma is a clinicopathological entity which has aroused considerable controversy in the literature. The concept of carcinoma arising in an embryonic vestigium in the neck was originated by Volkman1 in 1882. Since that time sporadic reports and articles have denied the existence of such an entity. Thirty years ago this condition was thought to be more common than had previously been recognized. In 1928 Carp and Stout2 reported 4 cases among a total of 32 cases of "branchial anomalies." The following year McWhorter3 described 14 cases of "malignant epithelial tumors of the neck of unknown origin," while Hudson4 reported 6 and Reader5 reported 1. In 1935 Cryle6 added 28 cases of "branchial carcinoma" and Oliver7 included 80 cases in his article on carcinoma of branchiogenic origin. However, subsequent case reports have not borne out an increase in the incidence.