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Infant ectopic cervical thymus in submandibular region.

Y He¹, Z-Y Zhang, H-G Zhu

¹Department of Oral and Maxillofacial Surgery, Shanghai 9th People's Hospital affiliated to Shanghai Jiao-Tong University, School of Medicine, Shanghai, China.

International Journal of Oral and Maxillofacial Surgery

|January 9, 2008

Summary

Ectopic thymus, a rare condition, can present as a neck mass in infants. Surgical removal is effective for diagnosis and treatment, with no recurrence observed in this case.

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Area of Science:

Pediatric Surgery
Developmental Biology
Head and Neck Pathology

Background:

Ectopic thymic tissue can develop along the embryologic descent pathway from the mandible to the mediastinum.
These anomalies typically present as asymptomatic masses, but can occasionally cause symptoms.

Observation:

An 8-month-old boy presented with a tender, palpable mass in the right upper lateral neck.
Imaging revealed a 4cm x 4cm soft-tissue mass in the left submandibular region, with a normal mediastinal thymus confirmed preoperatively.

Findings:

Histopathologic examination of the resected mass confirmed thymic lymphoid tissue and epithelial cells.
Immunohistochemical analysis showed positive expression for LCA, CKpan, EMA, CD20, and CD43 antibodies.

Implications:

Submandibular ectopic thymus is an uncommon pediatric presentation requiring surgical resection for definitive diagnosis.
Confirmation of a normal mediastinal thymus pre-surgically is crucial to avoid inadvertent total thymectomy.