Ectopic Cervical Thymoma in a Patient Diagnosed With Graves Disease: A Systematic Literature Review

Abstract

Thymomas are benign thymic epithelial neoplasms, rarely found outside the anterior mediastinum. Although hyperthyroid states have been associated with thymic hyperplasia, only 3 thymoma cases have been previously reported in patients with Graves Disease (GD), all within the anterior mediastinum. Here, we report a case of ectopic cervical thymoma in a 22-year-old female patient previously treated for GD. The patient underwent ultrasonography, computed tomography, inconclusive fine-needle aspiration, and ultimately gross dissection for diagnostic workup and definitive treatment of an anterior neck mass, producing a 2.5 x 2.3 x 1.5 cm entity consistent with Masaoka stage I and Type B2 thymoma per WHO classification. The patient underwent an uncomplicated subsequent clinical course, with no adjuvant radiotherapy administered. After conducting a systematic literature review, we conclude that of the 109 cases of ectopic cervical thymoma reported, this is the first to describe a case of ectopic cervical thymoma in a patient with a past medical history of GD. For GD patients in stable euthyroid remission with the persistent or recurrent presence of an anterior neck mass, the extrathyroidal origin of the mass should always be considered, including the exceptional presence of a cervical ectopic thymoma.

Ectopic cervical thymoma: a rare entity in the anterior neck

“…Compared to thymomas found in the mediastinum, thymomas originating from ectopic cervical thymic tissue are uncommon and typically affect females with a median age of 53.5 years (range, 32-86 years) [1]. The diagnosis of ectopic cervical thymomas (ECT) can be challenging due to inconsistent clinical presentations and the prevalence of more common pathologies in this anatomical site [1,2]. ECT may be misidentified as thyroid cancer or lymphoma.…”