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An appropriate differential diagnosis depends upon location of the ectopic thymus. For cervical ectopic thymus, the differential diagnosis should include additional causes of neck masses. This includes common causes of neck masses in children, including: thyroglossal duct cyst. [6] [10] branchial cleft cyst. [10] dermoid cyst. [10]
The cause is usually a developmental abnormality arising in the early prenatal period, typically failure of obliteration of the second, third, and fourth branchial cleft, i.e. failure of fusion of the second branchial arches and epicardial ridge in lower part of the neck. Branchial cleft cysts account for almost 20% of neck masses in children. [1]
Males are more commonly affected. [6] Most cases occur in the first decade of life, as the thymus tends to atrophy after puberty. [3] This lesion usually affects the left side of the neck. [6] The cyst can be small as 1cm and as large as 26cm. The location can vary as well, from the angle of the mandible to as low as the mediastinum. [6]
A neck mass or neck lump is an ambiguous mass found in the neck area. There are many different possible causes, [1] including head and neck cancer [2] and congenital conditions like branchial anomalies and thyroglossal duct cysts. [3]
Thyroglossal cysts can be defined as an irregular neck mass or a lump which develops from cells and tissues left over after the formation of the thyroid gland during developmental stages. [ 1 ] Thyroglossal cysts are the most common cause of midline neck masses and are generally located caudal to (below) the hyoid bone.
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A common sign is a neck growth. It may be found at birth, or discovered later in an infant after an upper respiratory tract infection. [8] Cystic hygromas can grow very large and may affect breathing and swallowing. Some symptoms may include a mass or lump in the mouth, neck, cheek, or tongue. It feels like a large, fluid-filled sac.
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