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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults

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Cervical thymic cysts in adults.

Nikolaos Michalopoulos¹, Theodossis S Papavramidis, Georgia Karayannopoulou

¹3rd Department of Surgery, AHEPA University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. nickos.michalopoulos@gmail.com

Thyroid : Official Journal of the American Thyroid Association

|May 21, 2011

Summary

Cervical thymic cysts (CTCs) are rare adult neck masses, often asymptomatic and misdiagnosed. Surgical excision is the treatment of choice for these benign lesions.

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Area of Science:

Head and Neck Surgery
Endocrinology
Pathology

Background:

Cervical thymic anomalies include ectopia, cysts, and thymomas.
Cervical thymic cysts (CTCs) are rare benign neck masses in adults, with prevalence less than 1% of cervical masses.
CTCs are typically diagnosed in childhood but can present in adults, often missed preoperatively.

Observation:

A systematic literature review identified 36 adult patients with CTCs.
The mean age of affected patients was 36 years, with a male/female ratio of 4/5.
Most CTCs were asymptomatic and diagnosed post-surgery via pathology.

Findings:

In most cases, thymic cysts were not included in the preoperative differential diagnosis.
Surgery is the recommended treatment, requiring careful preoperative assessment of cyst size, location, and relation to vital neck structures.
Surgical excision, often via a transverse cervical incision, can be challenging due to the proximity of CTCs to the carotid sheath and major nerves.

Implications:

CTCs are uncommon causes of neck swelling and frequently misdiagnosed preoperatively.
Surgical excision followed by histological examination confirms the diagnosis.
Cervical thymic cysts should be considered in the differential diagnosis of cervical cystic masses in adults.