Weekly Chest CasesArchive of Old Cases

Case No : 507 Date 2007-07-16

  • Courtesy of Woo Sung Koo, MD, Yeon Joo Jeong, MD, Kun-Il Kim, MD. / Pusan National University Hospital, Korea
  • Age/Sex 70 / F
  • Chief ComplaintLeft neck swelling
  • Figure 1
  • Figure 2
  • Figure 3
  • Figure 4

Diagnosis With Brief Discussion

Diagnosis
Ectopic (cervical) thymic epithelial tumor (Thymic carcinoma WHO type C)
Radiologic Findings
Radiologic Findings: Contrast enhanced chest CT scans, obtained at the levels of the lower poles of both thyroid glands and the thoracic inlet, demonstrate a heterogeneously enhancing soft tissue mass in the superior mediastinum. This mass shows increased FDG uptake (maximum SUV 5.5) on integrated PET-CT.
Surgical exploration was performed and a tumor was resected. Grossly, this mass was well encapsulated and not connected with thyroid gland. Normal thymic tissue was not seen on the anterior mediastinum.
Brief Review
Thymus develops from the ventral portion of the 3rd and 4th pharyngeal pouches and descends into the anterior mediastinum by the sixth weeks of gestation.
Thymic ectopia results from the failure of this migration.
Cervical thymoma occurs more commonly in females than in males. Most cases occur near the thyroid gland and are misdiagnosed as thyroid mass. Differential diagnoses include thyroid mass, lymphoma, and metastasis.
References
1. JCAT 1991; 15:842-844
2. AJR 2004; 182:262-263
Keywords
Mediastinum, Malignant tumor,

No. of Applicants : 45

▶ Correct Answer : 4/45,  8.9%
  • - Maimonides Medical Center; Brooklyn, NY, USA Naomi Twersky
  • - IRSA, La Rochelle, France Denis Chabassiere
  • - EKH-Berlin, Germany Michael Weber
  • - IRSA La Rochelle, France Jean-Luc BIGOT
▶ Correct Answer as Differential Diagnosis : 20/45,  44.4%
  • - Dept. of radiology, Inje University Ilsan Paik Hospital, Korea Bae Geun Oh
  • - Yashodha Hospital, Hyderabad, Andhra Pradesh, India Satish Babu, Maddkuri
  • - Regional Imaging Riverina, Australia Rashid Hashmi
  • - Saint-etienne, France Antoine Marie
  • - Asan Medical Center, Korea Eun Jin Chae
  • - Dept. of Radiodiagnosis & Imaging, PGIMER, Chandigarh, India Ram Prakash Galwa
  • - Yongsan Hospital, College of Medicine, Chung-Ang University, Korea Jae Seung Seo
  • - NUH, nottingham, UK Rohit Kochhar
  • - China Medical University Hospital, Taiwan Jun-Jun Yeh
  • - E-Da Hospital, Taiwan Yu-Feng Wei
  • - CHR Annecy Hospital, France OlivierSegall
  • - Hospital Sotiria Athens Greece Delaveri kaith
  • - Homs National Hospital, Homs - Syria Rami Abou Zalaf
  • - Hospital Sotiria, Athens, Greece Vasilios Tzilas
  • - Annemasse, Polyclinique De Savoie, France Gay-Depassier Philippe
  • - Vital imaging centre, Mumbai, India Ganesh Agrawal
  • - Ultracare Coimbatore, India Debabrata Das
  • - Armidale Radiology, Australia Saurabh Khandelwal
  • - Zulekha Hospital, Dubai, Australia Julie Arora
  • - Max Hospital, New Delhi, India Vickrant Malhotra
▶ Semi-Correct Answer : 19/45,  42.2%
  • - Mackay Memorial Hospital, Taipei, Taiwan Chia-Fu Tsai
  • - UHL NHS Trust, UK. A. Donuru
  • - Aditya Imaging centre, Sayajigunj, Vadodara, Gujarat, India Vivek Patel
  • - Mumbai , India Rahul B Deshmukh
  • - Annecy hospital, France Gilles Genin
  • - Anandnagar, Hingne Khurd, Pune, India Bankim J.Amin
  • - PGIMER, Chandigarh, India Ram Prakash Galwa
  • - Vancouver General Hospital, Vancouver, Canada Owen Chiu
  • - Konkuk University, College of Medicine, Korea Jeong Geun Yi
  • - Ondokuz Mayis University, Samsun Turkey Cetin Celenk
  • - CHRU Lille hopital calmette, France Toledano Manuel
  • - KAUMS, Kashan, Iran Ebrahim Razi
  • - Diagnostic Center Guntur, India Sunil Almale
  • - Aarthi Advanced CT & MRI Scans, Tirunelveli, Tamil Nadu, India Sivasubramanian Srinivasan
  • - Hangang Sacred Heart Hospital, Korea Eil Seong Lee
  • - Dong-A university hospital, Busan, Korea Park Seong Hoon
  • - CHU, Grenoble, France MORONI Anne-Line
  • - Seoul National University Hospital, Korea Kwang Nam Jin
  • - CHU Grenoble, France Bing Fabrice
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