Cervical thymic anomalies—The Texas Children's Hospital experience

Abstract

Cervical thymic anomalies are a rare but necessary part of the differential diagnosis of a cervical mass. Computed tomography scan can both narrow the preoperative differential diagnosis and aid in surgical planning for thymic cyst excision. A full discussion of the embryology, clinical presentation, and management of cervical thymic cysts and a review of the current literature is presented.

Clinical management of cervical ectopic thymus in children

“…Symptoms, such as stridor, dyspnea, and/or dysphagia caused by compression of the trachea and/or esophagus, may occur in 10% of cases [8,17]. Wagner et al [7] reported that cervical masses in some patients experienced rapid enlargement after minor trauma, vaccination, or upper respiratory tract infection.…”

Cervical Thymic Cyst in an Adult

“…It is the main organ of the lymphoid system during infancy. Right and left portions of the thymic primordium descend down the neck during the sixth to eighth weeks of gestational life and fuse to form the gland [3]. Finally, thymus gland reaches its destination in anterior mediastinum behind the sternum.…”

Ectopic Left Cervical Thymic Tissue in Pediatric Age Group

“…Since CTCs represent less than 1% of cystic cervical masses, they are often overlooked in the broad differential diagnosis of children presenting with painless neck masses. It is important, however, for physicians to be able to efficiently and accurately diagnose CTCs since they can usually be surgically excised with little risk of postoperative recurrence [9]. The thymus gland is mainly originated from the third and fourth pharyngeal pouches in association with the inferior parathyroid glands.…”

“…The thymus gland is mainly originated from the third and fourth pharyngeal pouches in association with the inferior parathyroid glands. Right and left portions of the thymic primordium descend down the neck during the sixth to eight weeks of gestational life and fuse to form the gland [9]. There are three mechanisms for pathogenesis of ectopic thymus in the neck: aberrant descent, sequestration of thymic tissue and failure of involution [10].…”