Hemorrhagic Thymopharyngeal Duct Cyst Causing Airway Obstruction in an Infant

Abstract

Normal thymus gland development and descent most commonly lead to its anterior mediastinal location directly behind the manubrium of the sternum. However, congenital cervical thymic anomalies, which include thymic and thymopharyngeal duct cysts, may occur as a consequence of an arrest in descent, failure of involution, or as a sequestration of thymic tissue during descent. 4 These anomalies, although usually asymptomatic, may present with airway compromise in up to 7% of patients. 1 Current literature demonstrates increasing numbers of these potentially life-threatening lesions presenting in children under 2 years of age, with early misdiagnosis being a shared finding. We describe the case of a 2-month-old infant who developed life-threatening airway obstruction secondary to a rapidly enlarging hemorrhagic thymopharyngeal duct cyst.