Presentation
The patient presented with chronic neck pain and stiffness.
Patient Data
There is a well-defined lesion in the right side of the neck, just beneath the right submandibular gland, and anterior to the carotid sheath, without significant mass effect.
This lesion appears isointense to the thymus gland on all sequences (iso-intense to the muscles on T1 and hyperintense to the muscles on T2), compatible with ectopic thymus gland.
Normal alignment of the cervical spine.
No disc herniation.
Normal craniocervical junction.
No intrinsic masses or abnormal signal intensity of the cervical cord.
Ultrasound of the same patient shows a well defined hypoechoic soft tissue lesion with internal hyperechoic foci within it, findings which demonstrate the typical echotexture of the thymus gland, giving a speckled/starry sky appearance.
Case Discussion
The cervical ectopic thymus is a rare cause of a cervical mass in childhood. It develops secondary to failure of or incomplete descent, implantation or persistence of remnant tissue or failure of involution; resulting in a cervically positioned thymus above the brachiocephalic veins.
It may show regression in size, but residual focal thymic tissue may persist throughout life as an anatomical variant.
The radiological diagnosis is very important to avoid unnecessary biopsy and surgical intervention.
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