Glottic tuberculosis masquerading as early multifocal carcinoma.
The incidence of tuberculosis has progressively decreased in developed countries after the advent of antituberculous chemotherapy, but has recently been increasing again mainly due to migratory flows. Although common in the past and considered to be a prelethal event, laryngeal involvement has become a rarity. We report the case of a 52-year-old female smoker who complained of persistent aphonia. Videostroboscopy showed bilateral vocal fold erythroleukoplakias. A chest X-ray and CT scan aroused the suspicion of lung tuberculosis, which was confirmed by Ziehl-Neelsen staining for acid-alcohol-fast bacilli on bronchoalveolar lavage. Antituberculous chemotherapy rapidly improved the quality of her voice and led to complete disappearance of the vocal fold lesions. In conclusion, laryngeal tuberculosis may mimic an early glottic multifocal carcinoma and should therefore, despite its rarity, always be considered in the differential diagnosis of erythroleukoplakia-like lesions in order to avoid improper surgical treatment and voice damage.
Department of Otolaryngology, Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena, Milan, Italy. giovanna.cantarella@policlinico.mi.it
Giovanna
G
Cantarella
Davide
D
Pagani
Valter
V
Fasano
Gabriele
G
Scaramellini
D000995:Antitubercular Agents / Q000627:therapeutic use; D001044:Aphonia / Q000209:etiology; D002277:Carcinoma / Q000175:diagnosis*; D003291:Conversion Disorder / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D005931:Glottis / Q000473:pathology*; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D007822:Laryngeal Neoplasms / Q000175:diagnosis*; D007828:Laryngoscopy; D007971:Leukoplakia / Q000175:diagnosis / Q000209:etiology; D008875:Middle Aged; D012293:Rifampin / Q000627:therapeutic use; D012907:Smoking; D014387:Tuberculosis, Laryngeal / Q000175:diagnosis* / Q000473:pathology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis
D000995:Antitubercular Agents; D007538:Isoniazid; D012293:Rifampin