GOLDENHAR (1952) reviewed the literature relating to a syndrome consisting of epibulbar dermoids or lipodermoids, auricular appendices, and certain skeletal anomalies. Forty such cases or variants thereof have so far been recorded and Sugar (1966) added three more. We have recently seen an infant with ocular epibulbar dermoids, auricular appendices, congenital hydrocephalus, meningo-encephalocele, and a nasal deformity due to malunion of the medial and lateral nasal folds on the right side. It would appear that hydrocephalus has not previously been described in association with the oculo-auricular syndrome of Goldenhar.Case Report A male infant aged 4 months was brought to the Ophthalmological Department in January, 1967. There were several epibulbar dermoids on the limbus in both eyes (Fig. 1). The right conjunctiva was congested and some muco-purulent discharge was visible; this appeared to be due to stenosis of the naso-lacrimal duct. The eyelids were normal. Movements were full so far as these could be assessed. The pupils reacted, and the eyes could follow bright objects. The fundi showed no papilloedema or optic atrophy.The left tragus (Fig. 2) was malformed and a few separate tubercles (auricular appendices) were situated anteriorly.

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The complex embryology of the anterior mediastinum makes it home to an array of primary neoplasms tied to the presence of the thyroid and thymus glands in that compartment. While the occurrence of ectopic thyroid deposits in the extramediastinal thorax has not been convincingly established, the other three “Ts” of the classic “4T” mnemonic for the differential diagnosis of an anterior mediastinal mass have occurred in the lung parenchyma, pleural space, and endobronchially as primary tumors. Finding any of the three lesions – thymoma, teratoma, or B-cell lymphoma – in the chest outside the mediastinum is very unusual, but that possibility exists. Herein, we illustrate examples of this rare phenomenon.