Adult Cervical Thymic Cysts: A Narrative Review

Abstract

Objective Thymic cysts are rare benign neck masses, accounting for less than 1% of all cervical masses. This study aims to discern different presentations, investigations, and treatment options of thymic cysts in adults by reviewing prior published studies from January 2010 to October 2021 to bridge the knowledge gap since the last review by Michalopoulos in 2011. Moreover, we present a case of a 28-year-old male with a left cervical thymic cyst. Data sources Data were obtained from a literature search using the ScienceDirect, PubMed, ResearchGate, and Google Scholar databases. Methods and results This study retrospectively analyzes reported cases of adult cervical thymic cysts by collecting demographic data, patient presentation, duration, location, size, type of imaging, fine-needle aspiration, and surgical approach. Eighteen patients were included. Cysts were seen on the left (n = 9), right (n = 5), and midline (n = 4). The age of the patients ranged from 19 to 64 years. Most patients present with painless left-sided neck swelling. Computed tomography (CT) was the preferred imaging modality in most cases. Moreover, surgical excision was essential for therapeutic and diagnostic purposes. This study did not require institutional review board approval. Conclusion Adult cervical thymic cyst is a rare etiology. Nevertheless, a painless left-sided neck mass with no clear lower border should uphold thymic cyst as a differential diagnosis. MRI and CT scans are the preferred imaging modalities for preoperative planning. Surgical excision is mandatory for treatment and histological confirmation. As of October 2021, around 54 cases of adult thymus cysts had been reported to the best of our knowledge and review.