Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Intermittent Suprasternal Neck Mass Caused by Herniation of Ectopic Thymus: Report of Two Cases

Document Type : Case Report

Authors
Kai- Jun Tey 1
Bee-See Goh 1
Faizah Mohd-Zaki 2
1 Department of Otorhinolaryngology, Head and Neck Surgery, University Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
2 Department of Radiology, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
10.22038/ijorl.2020.45727.2501
Abstract
Ectopic thymus is an uncommon cause of neck masses in children that frequently present as lateral cervical swelling especially on the right side.
 
Case Report:
We report two cases with atypical clinical presentation of ectopic thymus and superior herniation of normal thymus. Both of the patients manifested as intermittent midline mass at the suprasternal region during Valsalva manuevre. Unique ultrasound features with the location along the thymic descent together with dynamic assessment of the organ movement were essential to reach the correct diagnosis. Conservative approach was considered in these patients considering the necessity of thymus in the process of puberty.
 
Conclusion:
High index of suspicion is of utmost importance when encounter patient with similar clinical manifestation to avoid unnecessary diagnostic modalities and surgeries. Accurate diagnosis will also alleviate parents’ anxiety.
Keywords
Ectopic
Thymus
Valsalva
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Iranian Journal of Otorhinolaryngology
Volume 32, Issue 6
November and December 2020
Pages 391-395