A Giant Thornwaldt Cyst: Case Report

Abstract

Thornwaldt cyst develops if the opening of the bursa to the nasopharynx is obstructed due to infections, adenoidectomy, or ra- diotherapy. In this manuscript, a 53-year-old man who was admitted to the hospital with the complaint of nasal obstruction was discussed. In his nasopharyngoscopic examination, a smooth-surfaced, frustrating coana was found. Computerized tomography revealed a cystic lesion. This lesion was not destroying the bones, and it was marsupialized under general anesthesia with the diagnosis of Thornwaldt cyst. Lesions in the nasopharynx can be overlooked in patients who are admitted with the complaint of nasal obstruc- tion, since nasal pathologies are concentrated on. In patients presenting with this complaint, the nasopharynx should be evaluated before suggesting medical treatment. Endoscopy, which is an easy, inexpensive, and comfort- able method, should be performed, and Thornwaldt cyst, among nasopharyngeal pathologies, should also be con- sidered. In this case report, a patient diagnosed with Thornwaldt cyst was evaluated in the article with the literature. CASE REPORT A 53-year-old male patient, who had been treated for a diagnosis of allergic rhinitis due to increasing nasal obstruc- tion for 3 months, applied to the outpatient clinic, because his complaints still continued. In his medical history, it was found that he had been being followed up and treated for a diagnosis of mitral valve prolapse for 24 years, and he had been using coumadin for 9 years. Moreover, the patient did not report previous nasopharyngeal surgery, nasotracheal intubation, and radiotherapy applied on the nasopharynx. The posterior rhinoscopy examination revealed the presence of a round, smooth-surfaced, semisolid mass hav- ing mucosal defects and serous secretion on it (Figure 1). Other otorhinolaryngological examination results were normal. In axial and coronal CT images of the patient, a 2.4x3.4-cm-sized, well-circumscribed cystic mass that was covering the nasopharynx was found. Intracranial extension of the mass and findings of destruction in the sphenoid bone were not observed (Figure 2). The patient was pre-diagnosed with Thornwaldt cyst and prepared for surgical intervention. The nasopharynx was reached through the nose with a 0 o