Case 20 - page 2 Diagnosis Discussion Wattles, more appropriately termed cartilaginous choristomas, are pedunculated unilateral or bilateral masses. Their cartilaginous center may extend to the platysma muscle, or there may be fibrous bands attached to the sternocleidomastoid muscle or pharyngeal wall. The sex distribution appears to be equal and a family history of similar branchial anomalies is positive in ten percent of cases. The embryologic origin of the wattle is controversial.
Some authors feel the wattle is derived from the branchial arch.
This is mainly due to the location on the neck, the rare association with adjacent branchial sinuses, and the occasional finding of associated epithelial nests. Others, however, propose that wattles are of ectopic auricular origin since they are composed of elastic cartilage rather than the hyaline cartilage of the branchial arch. This latter concept is supported by our case which did stain with Verhoeff-van Gieson as elastic cartilage. The treatment of choice is excision. It is important, however, to remember that wattles may communicate with deeper structures or be associated with a congenital sinus tract.