Rare thymopharyngeal duct cyst presentation in an adult patient

Retained thymic tissue may occur anywhere along the path of descent of the thymus. Cervical thymic cysts are a rare cause of benign neck masses. Thymopharyngeal duct cysts are thymic cysts that span the length of the neck and extend towards the mediastinum. These lesions are rare and classically have been described in paediatric patients. Here, we present the case of a 23-year-old woman with a left-sided neck mass, which was found to be a thymopharyngeal duct cyst. Multiple analytic modalities including the clinical presentation, imaging, operative findings and histology were required to confirm the diagnosis and are discussed below.

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Cervical Thymic Cyst: A Rare Differential Diagnosis in Lateral Neck Swelling

Case Reports in Otolaryngology ◽

10.1155/2013/350502 ◽

2013 ◽

Vol 2013 ◽

pp. 1-4 ◽

Cited By ~ 3

Author(s):

Vijendra Shenoy ◽

M. Panduranga Kamath ◽

Mahesh Chandra Hegde ◽

Raghavendra Rao Aroor ◽

Vijetha V. Maller

Keyword(s):

Differential Diagnosis ◽

Neck Mass ◽

Thymic Cyst ◽

Lateral Neck ◽

Neck Swelling ◽

Thymic Tissue ◽

Neck Masses ◽

Rare Differential Diagnosis ◽

Thymic Cysts ◽

Lateral Neck Swelling

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.

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Prevalence and pattern of neck masses in pediatric patient: in Aseer Central Hospital, KSA

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20174206 ◽

2017 ◽

Vol 3 (4) ◽

pp. 791

Author(s):

Jibril Yahya Hudise ◽

Khalid Ali Alshehri ◽

Radeif Eissa Shamakhey ◽

Ali Khalid Alshehri

Keyword(s):

Pediatric Patient ◽

Histopathological Examination ◽

Statistical Tests ◽

Age Groups ◽

Neck Mass ◽

Anatomical Location ◽

Histopathological Diagnosis ◽

Central Hospital ◽

Duct Cyst ◽

Neck Masses

Background: Neck masses are a common complaint in children worldwide, and constitute a major indication for surgical consultation in many pediatric surgical centers. Most of the neck masses in children are benign in their nature and clinical course. The broad spectrum of etiology of neck masses that ranged from congenital benign to acquired neoplastic lesions is varied and related to multiple factors. This retrospective study was done with the objective to assess the distribution of neck masses related to gender, age, pathology, and anatomical location of neck masses in Aseer Central Hospital. Methods: Medical records of 62 patients with neck masses were collected from the department of pathology at Aseer Central Hospital KSA. The cases were reviewed for data on gender, age, the type of origin tissue, the type of lesion, and the anatomical location. Comparison between genders, age groups, and tissue origins were performed. All statistical tests were performed with SPSS software. We exclude thyroid, parathyroid and salivary gland masses. Results: Over a period of 5 years, a total of 62 patients 53.2% and women 46.8% had neck masses resected for pathological assessments. The age of presentation was ranging from 1 to 14 years. 22.6% developed in (from 1 years to 5 years old), 38.7% developed in (6 to 10 years), and 38.7% developed, in (11 to 14 years). The histopathological diagnosis of the neck masses were congenital 40.3%, inflammatory 33.9%, and malignant tumor 25.8%. Conclusions: The differential diagnosis of the pediatric neck mass includes a wide array of congenital, inflammatory, benign and malignant lesions. The exact diagnosis may only be obtained by histopathological examination. In our study the most common masses in pediatric patient thyroglossal duct cyst, all midline masses are congenital.

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Thyroglossal duct cyst anterior to the sternum: a novel presentation of a common lesion

BMJ Case Reports ◽

10.1136/bcr-2020-236515 ◽

2020 ◽

Vol 13 (11) ◽

pp. e236515

Author(s):

Jordan Whitney Rawl ◽

Nicholas Armando Rossi ◽

Matthew G Yantis ◽

Wasyl Szeremeta

Keyword(s):

Hyoid Bone ◽

Neck Mass ◽

Thyroglossal Duct Cyst ◽

Tongue Protrusion ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Neck Masses ◽

Close Proximity ◽

Sistrunk Procedure ◽

Thyroglossal Duct Cysts

Thyroglossal duct cysts (TDCs) arise in roughly 7% of the general population and are typically diagnosed in childhood within the first decade of life. Typically, patients present with a painless, midline neck mass in close proximity to the hyoid bone which classically elevates with deglutition and tongue protrusion. We present a case of TDC found anterior to the sternum, a major deviation from the classical understanding of this lesion. The patient was treated successfully with modified Sistrunk procedure. This case underscores the need for clinicians to maintain a wide differential while working up paediatric patients presenting with neck masses. Furthermore, we emphasise that TDC must always be considered in cases of midline paediatric neck masses, even when found in unusual locations such as presented here.

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Study on usual presentation of unusual neck masses in paediatric population

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20191555 ◽

2019 ◽

Vol 5 (3) ◽

pp. 593

Author(s):

Kamalpreet Singh ◽

Amrindarjeet Kour

Keyword(s):

Imaging Study ◽

Clinical History ◽

Paediatric Population ◽

Neck Mass ◽

Definite Diagnosis ◽

Branchial Cleft Cyst ◽

Duct Cyst ◽

Neck Masses ◽

Malignant Lesions ◽

Branchial Cleft

Background: A neck mass is defined as an abnormal lesion (congenital or acquired) that is visible, palpable, or seen on an imaging study. Neck masses are common in adults, but often the underlying etiology is not easily identifiable.Methods: Total of 36 patients (24 males and 12 females) who fulfill the above criteria were collected over 1-year and enrolled in this study. The clinical history was obtained from the parents or the proxy of the patients. Each patient was physically examined and a proper laboratory and/or radiological investigations were carried on to achieve the definite diagnosis. Results: According to the aetiology, the inflammatory category was the main group accounting for 16 cases (44.4%), followed by the congenital category 9 (25%), neoplastic 8 (22.2%), and then the non-inflammatory non neoplastic 3 (8.3%). Thyroglossal duct cyst was the most common congenital mass observed in 4 (11.1%) cases, followed by branchial cleft cyst, cystic hugroma, hemangioma and finally dermoid.Conclusions: The differential diagnosis of the pediatric neck mass includes a wide array of congenital, inflammatory, benign and malignant lesions.

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Enigma in the diagnosis of congenital neck masses: a prospective study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195708 ◽

2019 ◽

Vol 6 (1) ◽

pp. 159

Author(s):

Rajesh Radhakrishna Havaldar ◽

Anju Singh ◽

Priti S. Hajare ◽

Shama A. Bellad ◽

R. S. Mudhol

Keyword(s):

Prospective Study ◽

Bronchogenic Cyst ◽

Histopathological Examination ◽

Tertiary Care ◽

Needle Aspiration ◽

Neck Mass ◽

Care Hospital ◽

Duct Cyst ◽

Neck Masses ◽

A Prospective Study

Background: Head and neck swellings are common in routine otorhinolaryngologic practice. This study was done to assess the incidence and varied presentation of different congenital neck swellings.Methods: Hospital based prospective study done in the Department of Otorhinolaryngology at a tertiary care hospital from January 2017 to December 2018. A total of 28 patients with slow, progressive neck swellings were selected after excluding thyroid swellings and acute inflammatory neck swellings. All patients had no other complaints. After a thorough clinical examination and investigations like ultrasonography, fine needle aspiration cytology and radiological examination, surgery was done, and specimens obtained were sent for histopathological examination. Patients were followed up to 1 year. Results: 28 patients with congenital neck mass were studied. 15 were thyroglossal cysts, 7 were branchial anomalies, 5 were dermoid cysts and 1 was bronchogenic cyst. The most frequent congenital neck mass was thyroglossal duct cyst and fistula (53.57%) followed by, in descending order, cysts and fistulas of the branchial apparatus (25%), dermoid cysts (17.85%) and bronchogenic cyst (3.5%) respectively.Conclusions: The overall presentation in terms of age group, location, incidence and clinical features of congenital neck swellings is an enigma to the treating surgeon as well as the pathologist. The prevalence varies largely among centres. A knowledge of the varied differential diagnosis of slow progressive masses in the neck should be kept in mind while planning the surgical procedure for total removal of the lesion to avoid recurrence.

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Cervical Sympathetic Schwannoma: Case Report

Neurosurgery ◽

10.1097/00006123-200112000-00027 ◽

2001 ◽

Vol 49 (6) ◽

pp. 1452-1454 ◽

Cited By ~ 18

Author(s):

Michael Rosner ◽

Winfield Fisher ◽

Lisa Mulligan

Keyword(s):

Clinical Presentation ◽

Carotid Bifurcation ◽

Neck Mass ◽

Sympathetic Chain ◽

Vocal Cord Dysfunction ◽

Nerve Sheath Tumors ◽

Cervical Sympathetic Chain ◽

Neck Masses ◽

History Of ◽

Cervical Sympathetic

ABSTRACT OBJECTIVE AND IMPORTANCE Approximately 20 to 27% of neck masses in the parapharyngeal space may be benign nerve sheath tumors. Cervical sympathetic chain schwannomas or vagal nerve schwannomas are most common. We report a patient with a cervical sympathetic chain schwannoma. CLINICAL PRESENTATION The patient was a 47-year-old Caucasian man with a 7-month history of a painless, enlarging right neck mass. No hoarseness or Horner's syndrome was found preoperatively. Formal head and neck examination in the otolaryngology department revealed no vocal cord dysfunction. INTERVENTION By use of a standard right carotid incision, a tumor was identified growing from the cervical sympathetic chain posterior to the carotid bifurcation. A gross total resection was performed and a section of the cervical sympathetic chain was sacrificed. CONCLUSION Cervical sympathetic chain schwannomas are unusual tumors that require microneurosurgical resection for cure. We discuss the differential diagnosis, evaluation, surgical management, and pathological characteristics of such tumors and review the literature.

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Infected Thyroglossal Duct Cyst – A Diagnostic Dilemma

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/418 ◽

2021 ◽

Vol 10 (27) ◽

pp. 2044-2047

Author(s):

Ramhari Shankarrao Sathawane ◽

Kshitija Sanjay Bhakte ◽

Prajkta Sathawane Moharkar ◽

Vidyarjan Ashok Sukhadeve ◽

Mrunali Gajanan Chincholkar

Keyword(s):

Clinical Diagnosis ◽

Histopathological Examination ◽

Imaging Modality ◽

Neck Mass ◽

Thyroglossal Duct Cyst ◽

Diagnostic Dilemma ◽

Duct Cyst ◽

Thyroglossal Duct ◽

Neck Masses ◽

Cystic Masses

Neck swellings are usually the most visible and noticeable pathologies. These swellings include enlarged lymph nodes, swellings of thyroid gland, congenital / developmental cysts and lipomas.1 Cystic congenital neck masses are usually very well diagnosed in childhood. Congenital cystic masses of the anterior neck include thyroglossal duct cyst (TDC), branchial cleft cyst & cystic hygromas from uncommon pathologies to very rare thymic and bronchogenic cysts.2 Painless and soft or fluctuant nature of neck mass is usually the first clinical presentation in most cases. Ultrasonography (USG) helps to define the size, shape and extent of mass and confirms the cystic nature of lesion, whereas histopathological examination is the gold standard.3 The purpose of this article is to impress upon all that USG is an adjuvant imaging modality which helps in diagnosing cystic nature of the neck lesions. But most of the time, it cannot differentiate between dermoid cyst and thyroglossal cyst. The present case of infected thyroglossal duct cyst was reported to have diagnostic dilemma between clinical diagnosis and sonographic diagnosis. Histopathological examination confirmed the clinical diagnosis of Infected TDC.

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Cervical Thymic Cysts

Ear Nose & Throat Journal ◽

10.1177/014556139607501010 ◽

1996 ◽

Vol 75 (10) ◽

pp. 678-680 ◽

Cited By ~ 11

Author(s):

Jacqueline E. Jones ◽

Brian Hession

Keyword(s):

Computed Tomography ◽

Case Report ◽

Clinical Picture ◽

Neck Mass ◽

Cystic Mass ◽

Pathologic Examination ◽

Neck Masses ◽

History Of ◽

Surgical Options ◽

Thymic Cysts

Cervical thymic cysts are a rare cause of neck masses in children. This case report describes a three-year-old child with a several-month history of an enlarging neck mass, who was emergently admitted due to airway obstruction. Computed tomography revealed a large cystic mass extending from the oropharynx to the level of the mediastinum. Excision of the mass with pathologic examination revealed a thymic cyst. The clinical picture, the theories regarding development of these cysts, as well as surgical options for treatment, are discussed.

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Clinical presentation of congenital neck mass in children

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v18i1.10409 ◽

2012 ◽

Vol 18 (1) ◽

pp. 16-22

Author(s):

Mazharul Alam Siddique ◽

Mahbuba Hossen ◽

Ahmmad Taous ◽

Kazi Shamimus Salam ◽

Belayat Hossain Siddiquee ◽

...

Keyword(s):

Clinical Presentation ◽

Neck Surgery ◽

Neck Mass ◽

Medical College Hospital ◽

Paediatric Surgery ◽

College Hospital ◽

Medical College ◽

Neck Masses ◽

Common Location ◽

Complete Surgical Excision

Background: Congenital neck mass is a very common problem in children in Otolaryngology & Head-Neck Surgery and Paediatric Surgery Department but data of our country is inadequate and there is lack of published study. This study will help to diagnose congenital neck masses, evaluate the success of surgical treatment in our country.Objective: To assess the frequency of congenital neck mass in children and to see the clinical presentation of different congenital neck mass.Study design: Cross sectional prospective study.Place of study: Department of Otolaryngology Head & Neck Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Dhaka Medical College Hospital (DMCH)l, Dhaka and Mymensingh Medical College Hospital (MMCH), Mymensingh.Methodology: Patients below the age of 18 years with congenital neck mass who presented to three tertiary level hospitals from January 2010 to December 2010 were included in this study. Total thirty six patients were purposively selected. Age, gender, types of swelling and location were examined, investigations were done. Data was analyzed with SPSS software and was presented in the form of tables, diagrams and pie charts.Results: 36 patients with different congenital neck swelling were examined. Out of 36 patients, thyroglossal cysts were commonest- 21(58.33%). Other congenital lesions were as follows: Branchial cyst 7(19.44), Lymphangioma 3(8.33%), Haemangioma 3(8.33%), Dermoid cyst 2(5.55%). Midline was most common location 21 (58.33%).Conclusion: Congenital neck masses constitute important differential diagnosis for neck masses. These masses constitute diagnostic and therapeutic challenges for many clinicians. Correct diagnosis, safe and complete surgical excision requires sound knowledge of the location and extent of these masses. DOI: http://dx.doi.org/10.3329/bjo.v18i1.10409 Bangladesh J Otorhinolaryngol 2012; 18(1): 16-22

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T2 Gallbladder Cancer—Aggressive Therapy is Warranted

The American Surgeon ◽

10.1177/000313481608200612 ◽

2016 ◽

Vol 82 (6) ◽

pp. 518-521 ◽

Cited By ~ 2

Author(s):

Mohd Raashid Sheikh ◽

Houssam Osman ◽

Susannah Cheek ◽

Shenee Hunter ◽

Dhiresh Rohan Jeyarajah

Keyword(s):

Clinical Presentation ◽

Radical Surgery ◽

Radical Resection ◽

Gall Bladder Cancer ◽

Incidental Diagnosis ◽

Radical Cholecystectomy ◽

Node Positive ◽

Operative Findings ◽

Worse Prognosis

Treatment of gall bladder cancer (GBC) has traditionally been viewed with pessimism and lymph node positivity has been associated with worse prognosis. The aim of this study is to analyze the role of radical cholecystectomy in T2 tumors. All patients who underwent surgery for GBC between September 2005 and June 2014 were identified retrospectively. Data collected included clinical presentation, operative findings, and histopathological data. Twenty-five patients had incidental GBC diagnosis after cholecystectomy. Ten patients were T2 on initial cholecystectomy pathology and all underwent radical resection. Two patients were N1 on initial cholecystectomy pathology. Four were upstaged to N1 and two patients were upstaged to T3 after further surgery. Overall, 60 per cent patients with T2 disease had node positivity and 60 per cent were upstaged by further surgery. Eleven patients were diagnosed on imaging. Four of these patients were unresectable and six were either stage T3 or higher or node positive. Sixty per cent of T2 GBC was node positive and 60 per cent were upstaged with radical cholecystectomy. This finding supports the call for radical resection in patients with incidental diagnosis of T2 tumor on cholecystectomy. This study also emphasizes the role of radical surgery in accurate T staging.

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