Acute respiratory failure revealing a multilocular thymic cyst in an infant: a case report

Area of Science:

• Pediatric Surgery
• Thoracic Oncology
• Pediatric Pulmonology

Background:

• Multilocular thymic cysts are rare, benign mediastinal lesions typically presenting in older children or adults.
• In pediatric cases, symptoms usually appear after age two, often with mild respiratory complaints.
• This report details an unusual case of a multilocular thymic cyst diagnosed in a 3-month-old infant.

Purpose of the Study:

• To report an atypical presentation of a multilocular thymic cyst in a neonate.
• To emphasize the diagnostic challenges posed by rare pediatric mediastinal masses.
• To highlight the potential for severe respiratory compromise from these lesions in early infancy.

Main Methods:

• A 3-month-old female infant with persistent dyspnea and wheezing was admitted for acute respiratory failure.
• Initial treatment for suspected severe asthma, including corticosteroids and bronchodilators, proved ineffective.
• Diagnostic imaging with chest tomography revealed a multiseptated cystic mass in the anterior mediastinum, leading to urgent surgical excision and histopathological confirmation.

Main Results:

• The infant presented with severe respiratory failure requiring mechanical ventilation, mimicking asthma.
• Chest tomography identified an extensive multilocular cystic mass in the anterior mediastinum.
• Histopathological examination confirmed the diagnosis of a multilocular thymic cyst.

Conclusions:

• This case underscores the possibility of multilocular thymic cysts presenting in very young infants.
• The severe respiratory failure observed in this neonate was an atypical manifestation of this condition.
• Accurate and timely diagnosis through advanced imaging and biopsy is crucial for managing such rare pediatric thoracic pathologies.