Panoramic Radiograph Inquiry: Pseudocyst or Something Else?
A former student forwarded me a panoramic radiograph and asked about a potential pseudocyst.
“I recently saw a patient whose panoramic radiograph appears to show a possible mucous retention pseudocyst on her left side.”
In this case, the patient inserted a frozen corn dog into the left nasal cavity. You can clearly appreciate the characteristic shape on the panoramic radiograph — the battered exterior appears as a well-defined, homogeneous radiopacity continuous with the zygomatic process,
Its apparent continuity with the zygoma and zygomatic arch is simply a result of the superimposition of these structures on a 2D image — and yes, it does look remarkably like a corn dog. Cannot unsee it.
No corn dogs were harmed in the making of this post.
What you're actually seeing on this panoramic radiograph is completely normal anatomy. The structure in question is the inferior nasal turbinate (inferior concha), which on a panoramic image is superimposed over the maxillary sinus and can mimic a pseudocyst or mass.
A Chinese woman with chronic rhinitis was suffering from headaches and breathing issues. An exploratory x-ray revealed a bullet lodged in her head by her nostril.
She then remembered back 48 years ago to when she was 14, and walking along a path. The woman felt a stinging pain in her temple and started to bleed. She thought she’d been hit by a pebble; so her family cleaned her up and threw a bandage on it. Apparently she was shot.