Cervical thymic remnants in children § Melissa McCarty Statham a , Deepak Mehta b , J. Paul Willging a,c, * a Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati, Cincinnati, OH, United States b Division of Pediatric Otolaryngology, Children’s Hospital of Pittsburgh of UPMC, Pittsburgh, PA, United States c Department of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, ML 2018, Cincinnati, OH 45229-3039, United States Received 16 June 2008; accepted 20 August 2008 Available online 15 October 2008 International Journal of Pediatric Otorhinolaryngology (2008) 72, 1807—1813 www.elsevier.com/locate/ijporl KEYWORDS Thymic cyst; Thymic remnant; Neck mass Summary Objective: Define the clinical presentation, diagnostic value of preoperative ima- ging, surgical management, and outcomes of treatment of congenital cervical thymic remnants in children. Design: Retrospective cohort. Setting: Single tertiary care institution. Patients: 20 children who underwent excision of cervical thymic remnant, 1975—2006. Main outcomes measured: Utility of preoperative imaging to diagnose cervical thymic anomalies; success of surgical treatment of cervical thymic remnants. Results: A total of 20 children were identified, with an average age of 6.98 Æ 5.63 years. All ectopic thymus tissue was found in the embryonic distribution area asso- ciated with the third branchial pouch. Fourteen patients underwent excision of a cystic ectopic thymus. Four of these patients exhibited lesions isolated to the cervical region, and 10 patients displayed lesions involving cervicomediastinal areas. Six patients underwent excision of solid ectopic cervical thymus, and each of these was an unanticipated mass encountered during surgical dissection for other procedures. 83% of patients with solid ectopic cervical thymus presented at age 3 or younger. Physical exam and preoperative imaging correctly diagnosed thymic remnants in 15% patients. Resection of thymic remnants was successful in all patients, and there were no recurrences. Conclusions: Though rare, thymic remnants should be considered in the differential diagnosis of masses presenting in locations associated with derivatives of the third branchial pouch. Though preoperative imaging is helpful in identifying the extent of § Paper presented as poster at American Society of Pediatric Otolaryngology, April 2007, San Diego, CA. * Corresponding author at: Department of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, ML 2018, Cincinnati, OH 45229-3039, United Sates. Tel.: +1 513 636 4355; fax: +1 513 636 8133. E-mail address: paul.willging@cchmc.org (J.P. Willging). 0165-5876/$ — see front matter # 2008 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.ijporl.2008.08.013