Extrathoracic thymoma at the level III neck level

A male patient in his 60s was investigated for a suspicious mass in the level 3 neck space. His initial core biopsy was reported elsewhere as metastatic squamous cell carcinoma. Histological review as part of the multidisciplinary team (MDT) discussion policy at a local head and neck cancer centre was re-assessed as an unusual tumour of possible thymic origin and he underwent neck dissection which confirmed an extrathoracic thymoma. Correct identification of tissue origin by the histopathology team ensured the correct treatment course was recommended and avoided the burden of postoperative radiotherapy and adjuvant chemotherapy which currently lacks evidence.