We report a rare case of a first branchial cleft cyst surrounding the auricle. A 15-year-old girl presented with persistent drainage from the right posterior auricle. An elastic, soft mass extending from the posterior of the right auricle to the crus of the helix was observed. A cyst was located on the lower posterior part of the auricle. Magnetic resonance imaging detected a solitary cystic lesion encompassing the external auditory canal and the crus of the helix. Tumor resection was performed on the posterior auricular lesion, including the fistula, with careful consideration of the posterior auricular vessels. An additional incision was made at the anterior auricular lesion to remove the frontal portion of the tumor, which extended across the gap between the external auditory canal and the crus of the helix. Histopathological findings revealed a cystic tumor lined with stratified squamous epithelium and filled with keratinous material. There was no postoperative recurrence or complications such as facial paralysis.
