Fact-sheet: Thornwaldt cyst


Updated on 06/29/2020 at 10:53 AM

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Definition

Rounded cystic formation corresponding to a communication between the notochord and the nasopharyngeal endoderm.

It is located at the roof of the nasopharynx, within the prevertebral muscles.

Clinical features

  • Asymptomatic
  • Halitosis
  • Nasal obstruction
  • Eustachian tube dysfunction: middle Ear effusion or hearing loss

Ultrasound

Poorly visualized due to its location

CT

  • Hypodense, well-defined, midline lesion of the nasopharynx

MRI

Reference diagnostic examination

  • Classically T2 hyperintense and T1 hypointense
  • Sometimes T2 hypointense and T1 hyperintense due to hemorrhagic change and/or proteinaceous content
  • No enhancement after injection, however peripheral enhancement of the nasopharyngeal mucosa overlying the anterior aspect of the cyst