Chance finding of large 11 x 6 mm well defined multilocular lucency in the midline upper pharynx posterior adenoidal region in M 20 years of age. Developmental unilocular Tornwald mucous cysts are uncommon in this region seen in 0.06% of CTs and MRIs of this region.

However, they are unilocular and this lesion is multilocular and so the differential diagnosis includes

  • nasopharyngeal carcinoma (NPC)
  • up to 12% NPC’s are midline
  • minor salivary gland tumours
  • neurenteric cysts
  • meningocoele

The patient and their MD should be informed for an ENT follow up examination.

By Dr Douglas K Benn DDS PhD
Oral and Maxillofacial Radiologist
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