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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Case Report

Ectopic Cervical Thymus: A Common, yet Rarely Symptomatic Pediatric Neck Mass

Author(s): Lee Rousslang*, Jaren Meldrum, Rooks Veronica, Augustah Poutre and Timothy Biega

Volume 17, Issue 4, 2021

Published on: 27 October, 2020

Page: [544 - 548] Pages: 5

DOI: 10.2174/1573405616999201027214101

Price: $65

Abstract

Ectopic thymic tissue is an unusual finding that is generally asymptomatic. We present a case series of five pediatric patients with cervical ectopic thymuses. In two patients, the ectopic thymic tissue was symptomatic, and in three patients, it was an incidental finding. We highlight the need to include this anomaly in the differential diagnosis for a pediatric neck mass. We also propose observation, rather than surgical excision, as the treatment of choice for asymptomatic cervical ectopic thymus.

Keywords: Cervical ectopic thymus, symptomatic thymus, pediatric neck mass, asymptomatic, surgical excision, incidental finding.

Graphical Abstract
[1]
Kaufman MR, Smith S, Rothschild MA, Som P. Thymopharyngeal duct cyst: an unusual variant of cervical thymic anomalies. Arch Otolaryngol Head Neck Surg 2001; 127(11): 1357-60.
[http://dx.doi.org/10.1001/archotol.127.11.1357] [PMID: 11701074]
[2]
Nicollas R, Guelfucci B, Roman S, Triglia JM. Congenital cysts and fistulas of the neck. Int J Pediatr Otorhinolaryngol 2000; 55(2): 117-24.
[http://dx.doi.org/10.1016/S0165-5876(00)00384-0] [PMID: 11006451]
[3]
Lee EY. Imaging of Disorders Spanning the Spectrum from Childhood to Adulthood. Radiol Clin North Am 2020; 58(3): xv.
[http://dx.doi.org/10.1016/j.rcl.2020.02.004] [PMID: 32276709]
[4]
Zielke AM, Swischuk LE, Hernandez JA. Ectopic cervical thymic tissue: can imaging obviate biopsy and surgical removal? Pediatr Radiol 2007; 37(11): 1174-7.
[http://dx.doi.org/10.1007/s00247-007-0598-7] [PMID: 17851657]
[5]
Statham MM, Mehta D, Willging JP. Cervical thymic remnants in children. Int J Pediatr Otorhinolaryngol 2008; 72(12): 1807-13.
[http://dx.doi.org/10.1016/j.ijporl.2008.08.013] [PMID: 18922588]
[6]
Clark JJ, Johnson SM. Solid cervical ectopic thymus in an infant. J Pediatr Surg 2009; 44(7): e19-21.
[http://dx.doi.org/10.1016/j.jpedsurg.2009.04.010] [PMID: 19573646]
[7]
Kacker A, April M, Markentel CB, Breuer F. Ectopic thymus presenting as a solid submandibular neck mass in an infant: case report and review of literature. Int J Pediatr Otorhinolaryngol 1999; 49(3): 241-5.
[http://dx.doi.org/10.1016/S0165-5876(99)00198-6] [PMID: 10519705]
[8]
Herman TE, Siegel MJ. Cervical ectopic thymus. J Perinatol 2009; 29(2): 173-4.
[http://dx.doi.org/10.1038/jp.2008.89] [PMID: 19177048]
[9]
Raines JM, Rowe LD. Progressive neonatal airway obstruction secondary to cervical thymic cyst. Otolaryngol Head Neck Surg 1981; 89(5): 723-5.
[http://dx.doi.org/10.1177/019459988108900505] [PMID: 6799896]
[10]
Shah SS, Lai SY, Ruchelli E, Kazahaya K, Mahboubi S. Retropharyngeal aberrant thymus. Pediatrics 2001; 108(5): E94.
[http://dx.doi.org/10.1542/peds.108.5.e94] [PMID: 11694678]
[11]
Zarbo RJ, McClatchey KD, Areen RG, Baker SB. Thymopharyngeal duct cyst: a form of cervical thymus. Ann Otol Rhinol Laryngol 1983; 92(3 Pt 1): 284-9.
[http://dx.doi.org/10.1177/000348948309200314] [PMID: 6859746]
[12]
Saggese D, Ceroni Compadretti G, Cartaroni C. Cervical ectopic thymus: a case report and review of the literature. Int J Pediatr Otorhinolaryngol 2002; 66(1): 77-80.
[http://dx.doi.org/10.1016/S0165-5876(02)00210-0] [PMID: 12363426]
[13]
Purcell PL, Marquez Garcia J, Zawawi F, et al. Ectopic cervical thymus in children: Clinical and radiographic features. Laryngoscope 2020; 130(6): 1577-82.
[http://dx.doi.org/10.1002/lary.28248] [PMID: 31461169]
[14]
Aulino JM, Kirsch CFE, Burns J, et al. Expert Panel on Neurologic Imaging. ACR Appropriateness Criteria® Neck Mass-Adenopathy. J Am Coll Radiol 2019; 16(5S): S150-60.
[http://dx.doi.org/10.1016/j.jacr.2019.02.025] [PMID: 31054741]
[15]
Meier JD, Grimmer JF. Evaluation and management of neck masses in children. Am Fam Physician 2014; 89(5): 353-8.
[PMID: 24695506]
[16]
Schloegel LJ, Gottschall JA. Ectopic cervical thymus: is empiric surgical excision necessary? Int J Pediatr Otorhinolaryngol 2009; 73(3): 475-9.
[http://dx.doi.org/10.1016/j.ijporl.2008.10.031] [PMID: 19117616]
[17]
Scott KJ, Schroeder AA, Greinwald JH Jr. Ectopic cervical thymus: an uncommon diagnosis in the evaluation of pediatric neck masses. Arch Otolaryngol Head Neck Surg 2002; 128(6): 714-7.
[http://dx.doi.org/10.1001/archotol.128.6.714] [PMID: 12049570]
[18]
Bonomo A, Kehn PJ, Payer E, Rizzo L, Cheever AW, Shevach EM. Pathogenesis of post-thymectomy autoimmunity. Role of syngeneic MLR-reactive T cells. J Immunol 1995; 154(12): 6602-11.
[PMID: 7759894]

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