A case report of esophageal ectopic thymus in a child and literature review

Abstract

Objective To report one rare pediatric case of esophageal ectopic thymus (EET) and review the relevant literatures. Methods The clinical manifestations, diagnosis and treatment of one child with EET were reviewed. And systematic searches of the relevant literatures were performed for " ectopic thymus" , " children" and " infant" in the databases of China Knowledge Network, Weipu, Wanfang and PubMed. Results One girl was admitted with vomiting and transient suffocation for 24 hours. Ultrasound and computed tomography (CT) indicated a substantial mass at upper esophagus. During operation, tumor was located in esophageal lumen. Final histopathologic diagnosis was consistent with EET. She was discharged at Day 8 postoperatively. During a follow-up period of 3 months, there was no occurrence of vomiting, dysphagia or other discomforts. And upper gastrointestinal radiography indicated that esophageal mucosal folds remained intact and esophagus was not narrowed or dilated. Fifty-three cases of EET were collected from the literature search. Ectopic thymus occurred in neck (n=34) and thyroid (n=18). Most cases could be detected by ultrasound and their clinical symptoms were not obvious. Sometimes a painless mass was present around neck or thyroid. And the complication of EET was rare. Conclusions Ectopic thymus is extremely rare in esophageal lumen and ultrasonic detection is often not feasible. It is necessary to confirm mediastinal thymus preoperatively. Especially for infants and toddlers, radical thymectomy results in immune dysfunction. Esophageal endoscopy and angiography may aid in pinpointing the location of lesion. Key words: Thymus gland; Dystopia; Esophagus