Presentation
Referred for MRI scan of brain with history of recurrent complex partial seizure. This is an incidental finding.
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
The MRI scan of the brain demonstrates bilateral tubular lesions in the well defined cystic mass lesions in the fossae of Rosenmuller, measuring 2 x 1 cm and 3 x 1.5 cm in size on the right and left sides respectively. The lesion in the left side bulges into the nasopharynx. The right sided lesion has high signal intensity in T1 W low signal intensity on T2W image. The left sided lesion has low signal intensity in the T1W image and high signal on T2W & FLAIR images respectively.
Appearances are that of mucous retention cysts in the bilateral fossa of Rosenmuller.
Case Discussion
The fossa of Rosenmuller is posterolateral recesses of the nasopharynx, which is the site of origin of up to 50% of nasopharyngeal carcinomas 1. Cystic lesions of the nasopharynx are rare but it is essential to differentiate two entities, as they have totally different clinical course and management.
Differential diagnosis of cysts in the fossa of Rosenmuller is somewhat different from the midline lesions:
mucous retention cysts (66%)
intra-adenoid cysts
oncocytic cyst
branchial cysts
Tornwaldt's cyst presents in the midline within the nasopharynx 3.
The highest prevalence of mucous retention cyst is found in the age group 41-50 2. There is further, a significant correlation between human immunodeficiency virus infection and mucous retention cysts 2.
Contributed by Dr. (Mrs) Tamara Rajapakse and Dr. S. Maniharan.
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