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Bilateral Mucopyocele of the Torus Tubarius Presenting as Headache

Aria Jafari, MD1; Joseph Acevedo, BS2; Marc Lebovits, MD3
[+] Author Affiliations
1Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, University of California San Diego, San Diego
2School of Medicine, University of California, San Diego, La Jolla
3Division of Head and Neck Surgery, Department of Surgery, Veterans Affairs Hospital, San Diego, La Jolla, California
JAMA Otolaryngol Head Neck Surg. 2016;142(1):101-102. doi:10.1001/jamaoto.2015.2568.
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This case report describes a patient with refractory headache with incidental bilateral nasopharyngeal cysts later confirmed to be mucopyoceles.

Cystic lesions of the nasopharynx are typically asymptomatic and are often discovered incidentally with imaging or endoscopic examination. The etiology of these lesions can be either congenital or acquired. Acquired lesions, such as mucoceles, salivary duct cysts, oncocytic (Warthin) cysts, intra-adenoid cysts, and abscesses, occur throughout the nasopharynx and are associated with local trauma, such as surgery, radiation, or neoplastic or infectious processeses.1 Given their natural history, bilateral acquired lesions are an exceedingly uncommon presentation.2

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Figure 1.
Bilateral Nasopharyngeal Lesions Shown on T2-Weighted Axial Noncontrast Magnetic Resonance Imaging

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Figure 2.
Intraoperative Endoscopic View of the Right Nasopharynx

A, Endoscopic view of the right nasopharynx and an enlarged, cystic-appearing torus tubarius (TT). B, Suction is placed in the eustachian tube orifice. C, Draining purulence after biopsy was obtained. ETO indicates eustachian tube orifice; FoR, fossa of Rosenmüeller; NP, nasopharynx.

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