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Case report
Challenges in diagnosing ectopic thymus tissue in children
  1. Laura Claes1,
  2. Amélie Dendooven2 and
  3. Jaques van Heerden1,3
  1. 1 Paediatrics, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
  2. 2 Department of Pathology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
  3. 3 Paediatric Haematology and Oncology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
  1. Correspondence to Dr Jaques van Heerden, jaquesvanheerden{at}


The presentation of a fast-growing cervical mass necessitates prompt attention due to risk of the mass effect on vital structures and requires preferential screening for infections, bleeding and malignancies in an extensive list of differential diagnoses. This case report describes a 4.5-year-old boy with a fast-growing, unilateral lesion in the neck, with clinical features in keeping with malignant characteristics. Surgical excision with pathocytological examination revealed an exceptional diagnosis of haemorrhage in an ectopic cervical thymic cyst. Thymic cysts are a rare cause of unilateral masses in the neck, usually presenting as an asymptomatic, painless, slow-growing or stable mass anywhere along the thymopharyngeal duct. Spontaneous haemorrhages in thymic tissue can occur, often due to coagulation defects. Treatment of symptomatic thymic cysts is based on surgical excision. Partial resection of the thymus should be encouraged if possible, since clinical consequences of removing all thymic tissue in children are still unclear.

  • congenital disorders
  • immunology
  • paediatrics
  • paediatric oncology

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  • Contributors LC and JvH were the main clinicians whilst AD was the pathologist on the case. All authors contributed to the writing and reviewing of the case report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Parental/guardian consent obtained.