Tornwaldt cyst

Case contributed by Samah Al-Obaidi
Diagnosis almost certain


Non-specific headache not responding to analgesia with associated with occipital and neck pain.

Patient Data

Age: 50 years
Gender: Female

MRI shows a well-defined rounded submucosal lesion at the posterior nasopharyngeal wall centrally. It lies between the heads of the longus capitus muscles and measures 15 x 12 mm. It is bright on T1 WI, low-intermediate signal on T2 WI and FLAIR. No significant contrast enhancement is appreciated on post-contrast T1 WI. The lateral pharyngeal recesses are preserved with patent Eustachian tubes bilaterally.

Case Discussion

Tornwaldt cyst commonly presents as an incidental finding during imaging investigations. It is asymptomatic with no gender predilection. In some instances it can be complicated by infection. It is usually located in the midline of the roof of the nasopharynx causing a midline bulge. 

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