Conclusion
We report the first systematic review on the diagnosis and management of ECT in children. ECT is a benign and relatively rare condition. We identified 192 paediatric cases in the last 20 years. However, in the vast majority of these, an ECT was rarely considered in the pre-operative differential diagnoses. General Paediatric and ENT surgeons should always include this lesion in the differential diagnosis of neck lesions children as surgical intervention might not be appropriate in a small solid lesion as this could be the only functional thymic tissue and potentially involute over time. USS should be the initial investigation of choice but in clinically ambiguous cases, an MRI scan and/or FNA should be performed before planning appropriate surgical intervention.