Nemiroff Samuel, Chai Raymond, Fan Jun, Ramer-Bass Ilana
Internal Medicine Resident at Mount Sinai Morningside and West, New York, NY 10019, USA.
Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA.
J Clin Endocrinol Metab. 2024 Apr 19;109(5):1198-1201. doi: 10.1210/clinem/dgad635.
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 × 2.3 × 1.5-cm entity consistent with Masaoka stage I and type B2 thymoma per World Health Organization 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.
胸腺瘤是良性胸腺上皮性肿瘤，很少在前纵隔以外的部位发现。虽然甲状腺功能亢进状态与胸腺增生有关，但此前仅有3例胸腺瘤病例报道于格雷夫斯病（GD）患者，且均位于前纵隔内。在此，我们报告1例22岁曾接受GD治疗的女性患者发生异位颈部胸腺瘤的病例。该患者接受了超声检查、计算机断层扫描、不确定的细针穿刺活检，最终进行大体解剖以明确诊断并治疗前颈部肿块，结果发现一个2.5×2.3×1.5厘米的肿物，根据世界卫生组织分类符合Masaoka I期和B2型胸腺瘤。患者随后临床过程顺利，未接受辅助放疗。在进行系统的文献回顾后，我们得出结论，在已报道的109例异位颈部胸腺瘤病例中，这是首例描述既往有GD病史患者发生异位颈部胸腺瘤的病例。对于处于甲状腺功能正常稳定缓解期但前颈部肿块持续或复发的GD患者，应始终考虑肿块的甲状腺外起源，包括颈部异位胸腺瘤这种罕见情况。
