Abstract
Introduction. Thymic cysts are among the rarest cysts found in the neck. Nests of thymic tissue may be found anywhere along the descent of the thymic primordia from the angle of the mandible to the mediastinum. Mediastinal extension is seen in 50% of cervical thymic cysts. Case Report. We report an uncommon case of a 15-year-old male, who noted a painless, growing mass on left side of his neck of one-year duration. Computerised tomographic scan showed a multiloculated fluid density lesion with enhancing septae in the left parapharyngeal space, extending from the level of mandible up to C7 vertebral level. Here, we discuss the surgical aspect, histopathology, and management of this rare lateral neck swelling. Discussion. Clinically, in most cases, cervical thymic lesions present as a unilateral asymptomatic neck mass, commonly on the left side of the neck, and 75% of patients present before 20 years of age. Conclusion. Thymic cyst should be included as differential diagnosis of cystic neck masses. Greater awareness among the pathologists may decrease misdiagnosis.
Highlights
Thymic cysts are among the rarest cysts found in the neck
We report a rare case of thymopharyngeal duct cyst in a 15-year-old male, describing CT findings, intraoperative findings and histopathology
A study conducted in 20 years by Hsieh et al on 331 patients under the age of 18 years presenting with cystic neck masses found that 181 (54.68%) patients had thyroglossal cysts, followed by cystic hygromas (83 patients, 25.08%), branchial cleft cysts (54 patients, 16.31%), and bronchogenic cysts (3 patients, 0.91%), and nine cases (2.72%) remained unclassified
Summary
Cervical thymic cysts are unusual lesions usually presenting in the 1st decade of life [1]. Two varieties of thymic cysts have been described, thymopharyngeal duct cysts and cysts arising from degeneration of Hassall’s corpuscles within ectopic thymic remnants [2]. The presence of thymic tissue differentiates thymic cysts from 3rd and 4th branchial cysts [3]. We report a rare case of thymopharyngeal duct cyst in a 15-year-old male, describing CT findings, intraoperative findings and histopathology
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