Solid cervical ectopic thymus in an infant

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Abstract

Cervical ectopic thymus presenting as a neck mass is rare in a neonate. Just more than 100 cases have been reported in the literature with less than 10% occurring in infants. We report a case of solid cervical ectopic thymus in an asymptomatic 2-month-old boy. We review the literature and discuss the embryology, pathophysiology, diagnosis, and management of an infantile ectopic thymus.

Section snippets

Case report

An otherwise healthy 2-month-old infant presented with an asymptomatic left neck mass that increased in size for several weeks. On examination, there was a 2 × 3 × 2 cm soft, spongy mass in the left submandibular region. There was no associated erythema, skin changes, or cervical lymphadenopathy. Our differential diagnosis included a branchial cleft cyst, hemangioma, and cystic hygroma.

Ultrasonography demonstrated 3 small lymph nodes and no mass. Magnetic resonance (MR) imaging showed a 3.6 ×

Discussion

The thymus gland reaches its largest relative size between the ages of 2 and 4 years (about 15 g). Thymic size peaks at puberty with an absolute size of about 35 g [1]. The thymus then involutes and slowly decreases in size over one's lifetime.

Embryologically, the thymus is derived from all 3 germinal layers and arises primarily from the third pharyngeal pouch [1]. It descends from the piriform sinus and passes through the thyrohyoid membrane and out along the carotid sheath bilaterally [2].

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