Autopsy and Case Reports
Autopsy and Case Reports
Clinical Case Report and Review

Cervical Thymic Cyst with parathyroid tissue – a diagnostic conundrum

Deepika Gupta; Darwin Kaushal; Deepak Vedant; Rashim Sharma; Vikarn Vishwajeet; Poonam Abhay Elhence

Downloads: 2
Views: 781


Cervical thymic cysts are relatively rare benign cystic lesions that tend to be diagnosed clinically as branchial cysts, which usually present as painless, enlarging neck masses. They can occur anywhere along the normal path of descent of thymic primordia from the angle of the mandible to the sternal notch, with mediastinal extension observed in approximately 50% of cases. They are usually seen in the first decade of life on the left side with a male predominance. Here we report a case of a 15-year-old boy who presented to the hospital with left-sided neck swelling for about 2 months. The neck’s contrast-enhanced computed tomography (CECT) revealed a large, well-defined cystic swelling in the left neck region, showing peripheral enhancement, seen from the submandibular region to the superior mediastinum extending into the retrosternal region. Direct fine needle aspiration (FNA) was done, which showed a benign lesion with inflammatory and cystic characteristics, leading to the possibility of a branchial cyst. The cyst was completely excised surgically. Histopathology showed a thymic cyst with parathyroid tissue. The presence of thymic tissue with Hassall’s corpuscles is essential for the diagnosis. Knowledge of the clinical presentation, cyto-histological findings, and differential diagnosis of cystic cervical lesions in the pediatric population is important to diagnose this rare entity. Hence, though uncommon, when one comes across a cystic cervical region mass in children, a diagnosis of cervical thymic cyst should be kept in mind. Nonetheless, a definitive diagnosis depends on imaging findings as well as intraoperative findings and histopathological examination.


Cysts, Branchioma, Child Development, Pathology, Surgical


1 Barat M, Sciubba JJ, Abramson AL. Cervical thymic cyst: case report and review of literature. Laryngoscope. 1985;95(1):89-91. PMid:3965836.

2 Bruyère PJ, Moreau P, Ghaye B. Congenital thymic cyst. JBR-BTR. 2007;90(3):178-9. PMid:17696085.

3 Hsieh YY, Hsueh S, Hsueh C, et al. Pathological analysis of congenital cervical cysts in children: 20 years of experience at Chang Gung Memorial Hospital. Chang Gung Med J. 2003;26(2):107-13. PMid:12718387.

4 Nguyen Q, deTar M, Wells W, Crockett D. Cervical thymic cyst: case reports and review of the literature. Laryngoscope. 1996;106(3 Pt 1):247-52. PMid:8614183.

5 Michalopoulos N, Papavramidis TS, Karayannopoulou G, et al. Cervical thymic cysts in adults. Thyroid. 2011;21(9):987-92. PMid:21595559.

6 Terzakis G, Louverdis D, Vlachou S, Anastasopoulos G, Dokianakis G, Tsikou-Papafragou A. Ectopic thymic cyst in the neck. J Laryngol Otol. 2000;114(4):318-20. PMid:10845056.

7 Saggese D, Ceroni Compadretti G, Cartaroni C. Cervical ectopic thymus: a case report and review of the literature. Int J Pediatr Otorhinolaryngol. 2002;66(1):77-80. PMid:12363426.

8 Jaiswal AA, Garg AK, Ravindranath M, Mohanty MK. Multiloculated cervical thymic cyst-case report with review of literature. Egypt J. Ear Nose Throat Allied Sci. 2014;15(2):129-33.

9 Aydin AH, Çakli H, Canaz F, Uzun T. Uncommon childhood unilateral cervical giant thymic cyst. J Craniofac Surg. 2020;31(5):e520-2. PMid:32569056.

10 Fielding JF, Farmer AW, Lindsay WK, Conen PE. Cystic degeneration in persistent cervical thymus: a report of four cases in children. Can J Surg. 1963;6:178-86. PMid:13945066.

11 Guba AM Jr, Adam AE, Jaques DA, Chambers RG. Cervical presentation of thymic cysts. Am J Surg. 1978;136(4):430-6. PMid:707721.

12 Jindal A, Sukheeja D. Unilateral cervical thymic cyst in a child: a rare case report. J Sci Soc. 2016;43(1):24-6.

13 Daneshbod Y, Banani A, Kumar PV. Aberrant thymus and parathyroid gland presenting as a recurrent lateral neck mass: a case report. Ear Nose Throat J. 2006;85(7):452-3. PMid:16909820.

14 Berenos-Riley L, Manni JJ, Coronel C, Wilde PC. Thymic cyst in the neck. Acta Otolaryngol. 2005;125(1):108-12. PMid:15799585.

15 Hyde TL, Sellers ED, Owen M. Thymic cyst of the neck. Tex Med. 1944;39:539-45.

16 Pollosson A, Piery M. Un cas d’epithelioma primitif du thymus. Prov Med Lyons. 1901;15:1-4.

17 Sturm-O’Brien AK, Salazar JD, Byrd RH, et al. Cervical thymic anomalies--the Texas Children’s Hospital experience. Laryngoscope. 2009;119(10):1988-93. PMid:19653269.

18 Gaddikeri S, Vattoth S, Gaddikeri RS, et al. Congenital cystic neck masses: embryology and imaging appearances, with clinicopathological correlation. Curr Probl Diagn Radiol. 2014;43(2):55-67. PMid:24629659.

19 Fanous A, Morcrette G, Fabre M, Couloigner V, Galmiche-Rolland L. Diagnostic approach to congenital cystic masses of the neck from a clinical and pathological perspective. Dermatopathology. 2021;8(3):342-58. PMid:34449578.

20 Wee T, Lee AF, Nadel H, Bray H. The paediatric thymus: recognising normal and ectopic thymic tissue. Clin Radiol. 2021;76(7):477-87. PMid:33762135.

Submitted date:

Accepted date:

Publication date:

6213e486a953953c782b6e13 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections