Ectopic Thymic Tissue Presenting as an Epiglottic Mass Compromising a Neonatal Airway: A Case Report

Area of Science:

• Pediatric Otolaryngology
• Neonatal Airway Management
• Congenital Anomalies

Background:

• Epiglottic masses (EMs) are uncommon in neonates and can cause severe airway obstruction.
• Early and accurate diagnosis is crucial for managing life-threatening airway complications.

Observation:

• A neonate presented with a lingual epiglottic mass (EM) misdiagnosed twice in their home country as an elongated uvula and esophageal polyp.
• The true nature of the upper airway mass (UAM) was identified intraoperatively via rigid bronchoscopy.

Findings:

• Histopathological analysis of the lingual EM revealed fibrovascular tissue, cartilage, and notably, ectopic thymic tissue.
• A secondary mass in the left piriform sinus contained fibrovascular tissue, mucus glands, and skeletal muscle.

Implications:

• This case represents the first documented instance of ectopic thymic tissue presenting as an epiglottic mass.
• Highlights the importance of considering rare diagnoses in neonatal airway obstruction and the diagnostic challenges posed by unusual masses.