Cervical Thymic Cyst: Case Reports and Review of the Literature

Abstract

Due to its rarity, cervical thymic cyst is seldom included in the differential diagnosis of a neck mass. Approximately 80 cases have been reported thus far, and most of these cases have occurred asymptomatically in children and adults. Only 5 cases have involved patients younger than 1 year of age. The authors report four new patients with thymic cyst in the neck. Two of the patients were newborns in whom the cyst caused airway obstruction and dysphagia. All four patients underwent successful resection of the lesions, with complete resolution of symptoms. The embryology, histopathology, and differential diagnosis of cervical thymic cysts are also reviewed. The authors recommend that despite its infrequent occurrence cervical thymic cyst should be considered in the evaluation of neck masses in children.

Cervical ectopic thymus: a case report and review of the literature

“…Such anomalies are rarely diagnosed pre-operatively and can be easily confused with other neck lesions. Once diagnosed, surgery is the definitive treatment 6 if the mass is symptomatic and cosmetically unbecoming. Prior to surgery, the presence of a mediastinal thymus should be confirmed to prevent the risk of a total thymectomy.…”

“…Of the more specific origins proposed [5], the two favored theories for the development of cervical thymic cysts are the persistence of thymopharyngeal ducts (congenital) and the degeneration of Hassall's corpuscles within ectopic thymic remnants (acquired) [6]. 3 A cervical thymic cyst is usually a soft, unilocular or, more frequently, multilocular mass, 1 to 15 cm in width.…”

“…The diagnosis of cervical thymic tissue is rarely made preoperatively [6,9,10,11,12]. An estimated 80-90% of these lesions are asymptomatic, only 6% have symptoms, such as stridor, dyspnea and/or dysphagia due to compression of the trachea and/or esophagus [7,13].…”

“…For both diagnostic and therapeutic reasons, surgery is the treatment of choice for most neck masses, including cervical thymic lesions [4,6,12]. …”

Ectopic Left Cervical Thymic Tissue in Pediatric Age Group

“…Most of these lesions arise as a result of migration defects throughout thymic embryogenesis. Since 1901, about 90 cases of aberrant cervical solid and cystic thymic lesions have been reported in the literature and were recognized at either surgery or autopsy [1][2][3]. Approximately two-thirds of all reported cases were identified in children younger than 10 years [4].…”