Ahmad Iram, Kirby Patricia, Liming Bryan
1 Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.
2 Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Ann Otol Rhinol Laryngol. 2018 Mar;127(3):200-204. doi: 10.1177/0003489417749609. Epub 2017 Dec 31.
To share the diagnostic and management challenges created by an extremely rare airway lesion-the subglottic ectopic thymic cyst.
Case report and literature review.
We review the presentation, management, and clinical course of an infant who presented with a subglottic mass that was histologically confirmed as a thymic cyst. A brief literature review supplements the case presentation Results: We present the third described case of an ectopic thymic cyst presenting as a subglottic mass. The differential diagnosis of subglottic masses in neonates consists primarily of subglottic hemangioma and mucous retention cysts. Otolaryngologists must be prepared for unexpected findings when dealing with critical airways. We compare the presentation and management of our patient with the 2 previously described cases. We propose an embryologic theory for the origin of these rare lesions.
An ectopic thymic cyst is a rare and unexpected cause of neonatal stridor. Management of pediatric airway lesions must allow for unexpected findings at the time of diagnostic and therapeutic endoscopy. The appropriate management of subglottic thymic cysts is poorly defined, but close surveillance for recurrence is mandatory.
探讨一种极其罕见的气道病变——声门下异位胸腺囊肿所带来的诊断及管理挑战。
病例报告及文献综述。
我们回顾了一名婴儿的临床表现、治疗及临床病程，该婴儿声门下出现肿物，经组织学检查确诊为胸腺囊肿。简短的文献综述辅助病例报告。结果：我们报告了第三例表现为声门下肿物的异位胸腺囊肿病例。新生儿声门下肿物的鉴别诊断主要包括声门下血管瘤和黏液潴留囊肿。耳鼻喉科医生在处理关键气道时必须为意外发现做好准备。我们将该患者的临床表现及治疗与之前报道的2例病例进行比较。我们提出了关于这些罕见病变起源的胚胎学理论。
异位胸腺囊肿是新生儿喘鸣的一种罕见且意外的病因。小儿气道病变的管理必须考虑到诊断性和治疗性内镜检查时的意外发现。声门下胸腺囊肿的恰当管理尚缺乏明确界定，但必须密切监测复发情况。
