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Picture of the Month

Jeffrey S. Beard, MD, MC; Leonard Sperling, MD, MC
Arch Pediatr Adolesc Med. 1994;148(2):211-212. doi:10.1001/archpedi.1994.02170020097019.
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Denouement and Discussion 

Congenital Cartilaginous Rests of the Neck (Wattles) 

MANIFESTATIONS  Congenital cartilaginous rests of the neck are one of several anterior neck malformations resulting from abnormal development of thebranchial apparatus.1,2 Always present at birth, these lesions present asslightlyelevated protuberances usually located over or near the insertions of the sternocleidomastoid muscles in the lower anterior neck (Figure 1). The lesions may be unilateral or bilateral and most often consist ofnormal skin overlyinga firm, "springy" nodule with the consistency of cartilage. A less common but more dramatic variation of thecartilaginousrest is the "wattle," a fleshy, pedunculated lesion overlyingthe deepercartilaginouscomponent (Figure 2).3 The term wattle refers to the fleshy appendage beneath the throat ofcertain domestic animals, especially goats. Satyrs and fauns, mythologic creatures possessing bothhumanand goatlike features, are often depicted in classical art with wattles that are similar in appearance to those affecting human patients (Figure 3).Congenital cartilaginous rests of the neck can be reliably distinguished clinically from other developmental


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