Tornwaldt?s cyst is a benign cyst located in the upper posterior nasopharynx. It is a relatively rare lesion and most are small and asymptomatic whereas some cause nasal obstruction, postnasal drip, occipital headache or eustachian tube dysfunction. In our case a 28- year-old man presented with nasal obstruction since 10-years whose diagnostic nasal endoscopy showed a large well-encapsulated lesion arising from the posterior wall of the nasopharynx. A magnetic resonance imaging (MRI) was performed which was suggestive of a fluid filled cystic lesion. The patient underwent successful marsupialisation using endonasal endoscopic approach using rigid endoscopes and powered instrumentation. Histopathology of the aspirate revealed a respiratory lined epithelial cyst. Based on the clinical, radiological and histopathological findings a diagnosis of Tornwaldt?s cyst was made. We report this case to highlight the role of MRI in diagnosis and use of endoscopic assisted powered instrumentation for treatment of Tornwaldt?s cyst.
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