Ectopic Thymic Cyst of the Subglottis: Considerations for Diagnosis and Management

Ahmad, Iram; Kirby, Patricia; Liming, Bryan J.

doi:10.1177/0003489417749609

Cited by 8 publications

(14 citation statements)

References 10 publications

(12 reference statements)

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“…The high risk of transmural injury, the inability to coagulate small vessels, and the possibility of laser fiber rupture along with the threats of incomplete resection and local relapse led us to opt for an open approach. In case of subglottic thymic cysts, a 50.0% of failure of the first endoscopic treatment was described: the recurrence of a subglottic mass following a microlaryngeal marsupialisation was reported by Ahmad et al, 5 while no further surgical procedures were required following a microlaryngeal excision in the case reported by Sahhar et al 3…”

Section: Discussionmentioning

confidence: 99%

“…Otherwise, ectopic thymic tissue may develop through metaplasia of pluripotent endodermal cells below the vocal folds. 5…”

Section: Discussionmentioning

confidence: 99%

“…Otherwise, ectopic thymic tissue may develop through metaplasia of pluripotent endodermal cells below the vocal folds. 5 Physiologically, thymus undergoes hyperplasia during the first decade of life to reach its maximal relative size between 2 and 4 years of age and its maximal absolute size at puberty, with spontaneous involution following shortly before puberty.…”

Section: Discussionmentioning

confidence: 99%

“…In none of them has the correct diagnosis been suspected preoperatively. [3][4][5] The diagnostic and therapeutic management of this rare entity is here highlighted by presenting a successful case, discussed with a brief narrative literature review of case reports dealing with subglottic ectopic thymic tissue published in the English literature.…”

Section: Introductionmentioning

confidence: 99%

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Ectopic Thymus: An Unusual Case of Subglottic Mass

Paraboschi

Fati

Rizzo

et al. 2019

Ann Otol Rhinol Laryngol

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Objectives: The aim of our study is to report a case of a child with subglottic thymus that was suspected during diagnostic work-up for severe airway obstruction, excised surgically and confirmed with final histopathological examination. Moreover, we performed a narrative literature review to outline clinical and diagnostic features of this rare condition and to report suggestions for the management of subglottic masses. Methods: We report the case of a 7-month-old boy who was admitted to our Pediatric Airway Team Unit due to a history of worsening biphasic stridor and recurrent episodes of upper airway obstruction. The successful diagnostic work-up and a narrative literature of analogous cases of subglottic thymus were reported. Results: Ectopic thymus is a very rare condition in which thymic tissue is found outside the normal pathway of its embryonic migration. It usually presents as a cystic or, more rarely, solid mass, showing an indolent course toward spontaneous involution. In some cases, however, it becomes symptomatic exerting compression on surrounding vital structures. Due to its rarity, the initial diagnosis is normally mistaken with inflammatory diseases or malignancies and the definitive diagnosis is only achieved after histological examination of the excised specimen. To our knowledge, only four other cases of subglottic ectopic thymic tissue have been reported in the English literature so far and the diagnosis has never been suspected preoperatively. Conclusion: It is mandatory to consider ectopic thymic tissue in the differential diagnosis in children presenting with airways obstruction in order to prevent unnecessary, extensive, and exploratory surgery.

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Section: Discussionmentioning

confidence: 99%

“…Otherwise, ectopic thymic tissue may develop through metaplasia of pluripotent endodermal cells below the vocal folds. 5…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ectopic Thymus: An Unusual Case of Subglottic Mass

Paraboschi

Fati

Rizzo

et al. 2019

Ann Otol Rhinol Laryngol

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“…Von anderen wird eine CO 2 -Lasertherapie als sehr erfolgversprechendes Therapiekonzept angesehen [43]. [44], Schwannomen [45], Angiomyolipomen [46], ektopen Schilddrüsen [47], einem ektopen Ductus Thyreoglossus [48] oder einem Keimzelltumor der Trachea [49].…”

Section: Granularzelltumor (Gzt)unclassified

Subglottische Pathologien

Heyduck

Pickhard²,

Brosch

et al. 2019

Laryngo-Rhino-Otol

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ZusammenfassungSubglottische Pathologien sind sehr selten und manifestieren sich mit einem unspezifischen klinischen Erscheinungsbild in Form einer Gewebevermehrung auf Höhe des Ringknorpels bzw. der cranialen Trachea, was die Diagnose verschleiert. Typische Symptome solcher Patienten sind Heiserkeit, Reizhusten, ein Fremdkörpergefühl sowie Dyspnoe bzw. Stridor. Differenzialdiagnostisch kommen verschiedene Erkrankungen in Frage: Benigne Erkrankungen wie Folgen eines Traumas (z. B. Stenosen), Entzündungen (z. B. Pseudokrupp), rheumatische Erkrankungen (z. B. Granulomatose mit Polyangiitis) oder gutartige Tumore (z. B. Papillom, Hämangiom oder Granularzelltumor). Auch maligne Erkrankungen wie z. B. ein Plattenepithelkarzinom des Larynx, ein Chondrosarkom oder sehr selten eine laryngeale Lymphommanifestation müssen differenzialdiagnostisch in Erwägung gezogen werden. Idiopathische Formen ohne erkennbare Ursache sind ebenfalls denkbar. Zur Diagnosesicherung wird bei tumorösen Veränderungen in der Regel eine Probeexzision mit histologischer Aufarbeitung durchgeführt. Die Therapie erfolgt in Abhängigkeit vom histologischen Ergebnis – bei soliden tumorösen Erkrankungen üblicherweise chirurgisch oder durch eine Lokal- bzw. Systemtherapie im interdisziplinären Kontext.

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