Abstract
Thornwaldt cyst is benign, mucosal congenital cyst which is located in upper nasopharynx. It developed in nasopharyngeal bursa if opening of bursa is occluded due to infection or inflammation. It is rare congenital cyst present in nasopharyngeal bursa. Its incidence is 3% in adults [1]. The usual age of presentation is 2nd and 3rd decade [1]. It is usually asymptomatic and incidental finding on MRI but it can present as nasal obstruction, post nasal drip, halitosis, occipital headache, foreign body sensation in throat [1] [2]. Here we are presenting a case report of 23 years old male presented with foreign body sensation in throat since 5 months. On oral and nasal endoscopic examination cystic mass in nasopharynx seen, bulging in oropharynx. MRI shows cystic mass arising from left side of nasopharynx popping up in oropharynx. Cyst then excised with diode laser with both endonasal and transoral approach with zero degree rigid endoscope. Histopathology confirmed the cyst as thornwaldt cyst.
Highlights
Thornwaldt cyst is rare congenital cyst present in nasopharyngeal bursa formed by communication between notochord and nasopharyngeal endoderm [1] [3]
The usual age of presentation is 2nd and 3rd decade [1]. It is usually asymptomatic and incidental finding on magnetic resonance imaging (MRI) but it can present as nasal obstruction, post nasal drip, halitosis, occipital headache, foreign body sensation in throat [1] [2]
Nasal endoscopic examination reveals that cystic massarisisng from posterior wall of nasopharynx and coming in oropharynx, of around 2 × 2 cm, smooth surfaced, with broad base freely moving with act of swallowing (Figure 1)
Summary
Thornwaldt cyst is rare congenital cyst present in nasopharyngeal bursa formed by communication between notochord and nasopharyngeal endoderm [1] [3]. Its incidence has been reported to be 3% - 7% in the general population, 0.2% in magnetic resonance imaging (MRI), and 3% - 4% in postmortem studies [4]. Patient is usually asymptomatic but may present with nasal obstruction, foreign body sensation, nasal obstruction, halitosis, post nasal discharge. The diagnosis of this mass is usually incidental in MRI or autopsy. If symptomatic surgery with marsupialisation is method of choice
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