A patient with a "good nose".

We report on a 33-year-old man who underwent an odyssey of doctors for investigation of dysphagia. Eventually, a nasopharyngeal mass was found by several otorhinolaryngologists who repeatedly recommended biopsy or excision, because a polyp or fibroma was assumed on nasal endoscopy and MR imaging. However, we finally diagnosed the nasopharyngeal mass to be an ectopic pituitary gland after thorough clinical (cleft lip and palate) and radiological re-examination. Literally, the patient had a "good nose", since he refused manipulations on the nasopharyngeal tumour and assumably prevented inadvertent hypopituitarism. We conclude that biopsy or excision of nasopharyngeal masses should always be considered carefully, especially in patients with facial anomalies.