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Subglottic ectopic thymus mimicking airway haemangioma
  1. Sevasti Konstantinidou1,
  2. Colin R Butler1,2,
  3. Benjamin Hartley1 and
  4. Claire Frauenfelder1,3
  1. 1Paediatric Otolaryngology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
  2. 2Stem Cell and Regenerative medicine, UCL Great Ormond Street Hospital Institue of Child Health, London, UK
  3. 3Department of Surgery, The University of Adelaide, Adelaide, South Australia, Australia
  1. Correspondence to Dr Claire Frauenfelder; claire.frauenfelder{at}gosh.nhs.uk

Abstract

Subglottic haemangioma presents as progressive obstruction in the neonatal and infantile airway, with a soft lesion seen during endoscopy. Diagnosis is based on macroscopic findings, biopsy is not usually performed and propranolol is first-line treatment. In contrast, ectopic thymus is a rare differential diagnosis for subglottic mass made by histopathological examination after excision or autopsy. In this article, we present a case of an infant with a subglottic lesion with endoscopic features consistent with haemangioma. After initial clinical response to propranolol, the patient represented with progressive stridor no longer responding to therapy. Open excision of the lesion was performed, and histopathology revealed ectopic thymus tissue. In this case, ectopic thymus tissue mimicked the presentation of subglottic haemangioma, and confirmation bias persisted due to an apparent initial clinical response to treatment with propranolol. In cases of subglottic mass refractory to medical treatment, excision of the lesion should be considered.

  • ear
  • nose and throat/otolaryngology
  • paediatrics
  • dermatology
  • immunology
  • head and neck surgery

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Footnotes

  • Twitter @colin_r_butler, @ClaireFrau

  • Contributors I can confirm that SK has contributed significantly in this manuscript, by being involved in the patient’s care, collecting data and writing and editing the manuscript. I can confirm that CF, CB and BH have contributed significantly in this manuscript, by being involved in the patient’s care and writing and editing the manuscript. All authors have approved the final edition of the manuscript.

  • 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.

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