Hypermetabolic Tornwaldt cyst

Notochord formation begins between the third and fourth weeks of embryonic development. As the axial skeleton develops, the notochord regresses and eventually contributes to the formation of the nucleus pulposus of the intervertebral disks. Notochord regression can be variable, especially at the 2 poles of the skeleton, which results in the persistence of ectopic notochordal remnants. These remnants include benign entities (eg, ecchordosis physaliphora, benign notochordal cell tumor, Tornwaldt cyst, canalis basilaris medianus, fossa navicularis) or malignant lesions (eg, chordoma). We present a review of these lesions, their clinical presentations, and their typical radiographic appearances. Notochord remnants may have overlapping features in terms of their location and appearance; however, differentiation is crucial because the proper treatment and management may differ drastically. Familiarity with notochord development aids in understanding the characteristic locations of notochordal remnants. Noting the unique imaging findings of notochordal remnants can often help narrow the differential diagnoses.Learning Objective: To describe notochord development, normal regression during fetal life, and notochord remnants that give rise to anatomic variants, including benign and malignant lesions.

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Endoscopic Management of a Large Tornwaldt Cyst: A Case Report

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v35i2.1513 ◽

2020 ◽

Vol 35 (2) ◽

pp. 44

Author(s):

Wenrol Espinosa ◽

Michael Joseph David

Keyword(s):

Case Report ◽

Nasal Obstruction ◽

Cystic Mass ◽

Respiratory Epithelium ◽

Transoral Approach ◽

Endoscopic Management ◽

Nasal Discharge ◽

Histopathologic Examination ◽

History Of ◽

Tornwaldt Cyst

ABSTRACT Objective: To report successful marsupialization of a large Tornwaldt cyst using combined transnasal and transoral endoscopic surgery in a 7-year-old girl who presented with nasal obstruction. Methods:Design: Case ReportSetting: Tertiary Government Training HospitalPatient: One Result: A 7-year-old girl presented with an 11-month history of recurrent yellowish nasal discharge gradually associated with nasal obstruction. Examination revealed a large, well encapsulated, broad-based cystic mass in the nasopharynx immediately adjacent to the posterior choanae, continuing posterior to the soft palate (pushing the uvula anteriorly) and extending inferiorly to the epiglottic area. Computerized Tomography (CT) demonstrated a well-circumscribed, midline hypodense mass with fluid attenuation obstructing the nasopharyngeal area extending inferiorly to the oropharyngeal area. Endoscopic marsupialization via transnasal and transoral approach was successful, and a respiratory epithelium-lined cyst consistent with a Tornwaldt cyst was confirmed by histopathologic examination Conclusion: Combined transnasal and transoral endoscopic marsupialization is possible a for a large symptomatic Tornwaldt cyst in a pediatric patient with relatively smaller and complex nasal cavities.

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Tornwaldt Cyst: A Case Report Of Unusual Dental Symptoms

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v16i2.1119 ◽

2017 ◽

Vol 16 (2) ◽

Author(s):

Asfizahrasby Mohd Rasoul ◽

Norliwati Ibrahim

Keyword(s):

Case Report ◽

General Population ◽

Recurrent Infection ◽

Potential Space ◽

Epithelial Lining ◽

Asymptomatic Patients ◽

Pharyngobasilar Fascia ◽

Clinically Significant ◽

Tornwaldt Cyst

Introduction: Tornwaldt's (Thornwaldt's) or nasopharyngeal cyst is an uncommon developmental benign cyst located in the midline postero-superior wall of nasopharynx. Incidence reported in general population is 0.06%. It occurred in the potential space due to outpouching of ectoderm into the pharyngobasilar fascia at the site where notochord attached to pharyngeal ectoderm. The cyst developed when the epithelial lining of the pouch secrets mucous following recurrent infection or trauma of the nasopharynx. Although majority of the cases are asymptomatic, patients may present with clinically-significant nasal, ear or cervical symptoms. Thus, most of Tornwaldt cyst cases were reported under otorhinolaryngology (ORL)-associated journals. However, patient presented with dental symptoms has never been reported before. This case is the first one as such to be reported.

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Tornwaldt Cyst

Imaging in Otolaryngology ◽

10.1016/b978-0-323-54508-2.50015-7 ◽

2018 ◽

pp. 24

Keyword(s):

Tornwaldt Cyst

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Spontaneous Healing of the Crust Type of Nasopharyngeal Bursitis

Ear Nose & Throat Journal ◽

10.1177/0145561320980189 ◽

2020 ◽

pp. 014556132098018

Author(s):

Jae-Hoon Lee

Keyword(s):

Minimally Invasive ◽

Ulcerative Lesion ◽

Spontaneous Healing ◽

Invasive Method ◽

Pharyngeal Epithelium ◽

Crust Type ◽

Tornwaldt Cyst

The nasopharyngeal bursa is an invaginated space that links the remnants of the notochord with the pharyngeal epithelium. Nasopharyngeal bursitis can occur in the midline of the upper portion of the nasopharynx if the notochord remnants and midline recess continue to persist. Nasopharyngeal bursitis, also known as Tornwaldt cyst, can be divided into cystic and crusting types. Crust types are relatively rare. Electrocauterization of the ulcerative lesion of the crust type is an effective and minimally invasive method. This report presents a case of crust-type nasopharyngeal bursitis that heals spontaneously without electrocauterization therapy.

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Huge Tornwaldt Cyst With Otitis Media With Effusion

Ear Nose & Throat Journal ◽

10.1177/0145561319890159 ◽

2019 ◽

pp. 014556131989015

Author(s):

Jae-Hoon Lee

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Rare Case ◽

Otitis Media With Effusion ◽

Imaging Modality ◽

Posterior Wall ◽

Resonance Imaging ◽

Nasopharyngeal Airway ◽

Rare Lesion ◽

Tornwaldt Cyst

Tornwaldt cyst is a relatively rare lesion that is found in the posterior wall of the nasopharynx. It occurs in the midline bursa of the nasopharynx and represents a persistent communication between the roof of the nasopharynx and the notochordal remnants. Smaller cysts are usually asymptomatic; cysts exceeding a diameter of 1 to 2 cm may be symptomatic. Magnetic resonance imaging is the best imaging modality for diagnosing Tornwaldt cyst. We present a rare case of a huge Tornwaldt cyst completely obstructing the nasopharyngeal airway.

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