Multiloculated cervical thymic cyst

Abstract

In this study, we report a rare case of cervical thymic cyst in an 8-year-old child.

Cervical Thymic Cyst: A Unique Case Report with Related Embryogenesis

“…Observations like CTC location, longitudinal shape, frequent finding of the intrathoracic connection, and occasional finding of other endocrine tissue (parathyroid and less common thyroid) within the CTC support the congenital origin [3,5,9]. Few case reports presented longitudinal cysts with persistence patency throughout the entire course of the normal thymic descent, but they pinched off from larynx [2].…”

“…Few reports mentioned that the unilocular cyst is remnant of thymopharyngeal duct while multilocular cyst is acquired arising from degeneration of thymic Hassall's corpuscles, but microscopic studies multiple minute cysts sometimes detected in the walls of CTC indicate that one cyst has enlarged at the expense of the others (Dyer 1967) [3,9].…”

“…The cervical thymic cyst (CTC) is a rare benign lesion accounting for 0.3% -1% of all congenital neck masses [1]. It locates anywhere along the thymopharyngeal tract extending from hyoid to the anterior mediastinum with close vicinity to the carotid sheath (adjacent or within) [2,3]. CTCs are not usually found at birth, about two-third of cases presented in the first decade of life, most of the remainder were in the second, with only occasional cases in the third decade [4,5].…”

Diagnosis and Management of Cervical Thymic Cysts in Children

“…CT can generally help to differentiate thymic cysts from other cervical lesions, and MRI can be useful in determining the association of putative lesions with the thymus. CTCs are usually found close to the carotid sheath, between the internal jugular vein and the carotid vessels, while branchial cleft cysts are more commonly found superficial and lateral to both the internal jugular vein and carotid artery, and lymphangiomas are generally restricted to the posterior triangle of the neck [ 7 ]. While such imaging findings can be useful, the histopathological identification of thymic tissue containing Hassall’s corpuscles is generally necessary to definitely distinguish CTCs from other cervical masses [ 8 ].…”

“…Most CTCs can be completely excised with a transverse cervical incision [ 8 ]. However, it is critical that the existence of a mediastinal thymus be confirmed with MRI or FNAC prior to surgery because thymectomy during childhood can impair immune status later in life [ 7 ]. Close postoperative monitoring for evidence of neurovascular compromise (particularly aspiration) is warranted in all patients treated surgically for CTC (2).…”