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Dysphagia and Pharyngeal Cyst

Educational Objective
Based on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis.
1 Credit CME

A 73-year-old woman with a history of chronic cervical neck pain presented with complaints of globus sensation, dysphagia, and localized throat swelling. On examination, she had an approximately 1.5-cm mucosally covered mass on her left lateral pharyngeal wall that was cystlike in appearance. The remainder of her examination findings were normal. The patient reported that this cyst had been drained 2 years before with resolution of her symptoms. Contrasted computed tomographic (CT) imaging of her head and neck was obtained, which revealed a pharyngeal cyst that extended to the atlantoaxial joint (Figure, A). Further magnetic resonance imaging (MRI) of the area was obtained, which demonstrated communication of the cyst with the atlantoaxial joint (Figure, B and C).

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A. Juxtafacet cyst

Symptomatic juxtafacet cysts, or synovial cysts, of the spine are rare. They are usually located in the lumbar spine, with the cervical spine less commonly affected. The cyst typically has an extradural intraspinal extension arising from the facet joint, in this case, the atlantoaxial joint. These lesions are associated with other spinal conditions, such as osteoarthritis, spondylolisthesis, and disk degeneration.1,2 Depending on the location and size of the lesions, juxtafacet cysts of the cervical spine have been associated with upper extremity radiculopathy, myelopathy, and neck and shoulder pain.3 Rarely, do they present as pharyngeal masses causing dysphagia or globus sensation.4,5

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Article Information

Corresponding Author: Lauren S. Buck, MD, Department of Otolaryngology–Head and Neck Surgery, University of Mississippi Medical Center, 2500 N State St, Jackson, MS 39216 (lsbuck@umc.edu)

Published Online: August 13, 2020. doi:10.1001/jamaoto.2020.1767

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information.

References
1.
Linhares  D , Lobo  J , Pinto  R , Neves  N .  Atypical presentation of a cervical synovial cyst.   Eur Spine J. 2017;26(9):2267-2271. doi:10.1007/s00586-017-4947-4PubMedGoogle ScholarCrossref
2.
Found  E , Bewyer  D .  Cervical synovial cyst: case report.   Iowa Orthop J. 2011;31:215-218.PubMedGoogle Scholar
3.
Kim  DS , Yang  JS , Cho  YJ , Kang  SH .  Acute myelopathy caused by a cervical synovial cyst.   J Korean Neurosurg Soc. 2014;56(1):55-57. doi:10.3340/jkns.2014.56.1.55 PubMedGoogle ScholarCrossref
4.
Kao  CC , Uihlein  A , Bickel  WH , Soule  EH .  Lumbar intraspinal extradural ganglion cyst.   J Neurosurg. 1968;29(2):168-172. doi:10.3171/jns.1968.29.2.0168 PubMedGoogle ScholarCrossref
5.
Giger  R , Szalay-Quinodoz  I , Haenggeli  A , Dulguerov  P .  Ganglion cyst of the spinal anterior longitudinal ligament presenting as a retropharyngeal mass.   Am J Otolaryngol. 2002;23(6):390-393. doi:10.1053/ajot.2002.126323 PubMedGoogle ScholarCrossref
6.
Jabre  A , Shahbabian  S , Keller  JT .  Synovial cyst of the cervical spine.   Neurosurgery. 1987;20(2):316-318. doi:10.1227/00006123-198702000-00020 PubMedGoogle ScholarCrossref
7.
Costa  F , Menghetti  C , Cardia  A , Fornari  M , Ortolina  A .  Cervical synovial cyst: case report and review of literature.   Eur Spine J. 2010;19(suppl 2):S100-S102. doi:10.1007/s00586-009-1094-6Google ScholarCrossref
8.
Colen  CB , Rengachary  S .  Spontaneous resolution of a cervical synovial cyst: case illustration.   J Neurosurg Spine. 2006;4(2):186. doi:10.3171/spi.2006.4.2.186 PubMedGoogle ScholarCrossref
9.
Flis  DW , Wein  RO .  Nasopharyngeal branchial cysts—diagnosis and management: a case series.   J Neurol Surg B Skull Base. 2013;74(1):50-53. doi:10.1055/s-0032-1331020PubMedGoogle Scholar
10.
Ma  X , Li  W , Niu  C ,  et al.  Intraspinal bronchogenic cyst: series of case reports and literature review.   J Spinal Cord Med. 2017;40(2):141-146. doi:10.1080/10790268.2017.1279816 PubMedGoogle ScholarCrossref
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