Ectopic Hamartomatous Cervical Thymoma Presenting as a Posterolateral Neck Mass in a Pediatric Patient

✍ Scribed by Eric M. Jaryszak; Carol J. Langdoc

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 876 KB
• Volume: 119
• Category: Article
• ISSN: 0023-852X
• DOI: 10.1002/lary.20455

✦ Synopsis

Objectives: To present an unusual case of ectopic cervical thymoma in a pediatric patient and review the literature on this rare disorder.

Background:

The thymus develops primarily from the third branchial pouch forming the thymopharyngeal duct during the 6th week of gestation. It descends along a tract from the pyriform sinus to the mediastinum passing posterior to the glossopharyngeal nerve and lateral to the thyroid gland. Ectopic cervical thymomas have been most frequently described along this typical path of descent, however, rarely, they present in other cervical locations.

Methods: We present a case of a posterolateral ectopic cervical thymoma, the first such reported case, with review of imaging and pathology. We also review the English literature on ectopic cervical thymoma, including perioperative management, and discuss potential pitfalls in diagnosis and management.

Results: Only approximately 30 cases of ectopic hamartomatous cervical thymoma have been described in the English literature. Of these, the majority are in the supraclavicular region with a single report involving the submandibular gland and another involving the sternocleidomastoid muscle. There were no reports of this tumor in the posterolateral neck.

Conclusion: Ectopic cervical thymoma is an uncommon cause of a neck mass. It is important, however, to maintain this in the differential as there can be implications after removal in the perioperative period.