title: Tuberculosis of the cavum revealed by acute facial pain.
abstract: An 85-year-old woman presented for assessment of recurring episodes of intense hemifacial pain, mimicking trigeminal neuralgia, associated with tinnitus. A necrotic tumour of the cavum with compression of the left Eustachian tube and skull-base invasion was discovered on brain MRI. Although the tumour was initially thought to be malignant, the histopathological findings on the biopsy were compatible with tuberculosis, later confirmed by the cultures. F-18-fluorodeoxyglucose positron emission tomography (PET)/CT showed an intense signal of the cavum, cervical and mediastinal lymph nodes, and also of two small nodules of the apex of each lung. Currently, after 9 months of combined antituberculosis antibiotics, the initial lesion has almost disappeared from both PET scan and MRI. This case highlights the importance of systematically screening for tuberculosis in the assessment of nasopharyngeal tumours.
authors.affiliation: Service de Médecine Gériatrique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gilbert
authors.affiliation: Service de Maladies Infectieuses, Centre Hospitalier de la Croix-Rousse, Hospices Civils de Lyon, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Chidiac
authors.affiliation: Service de Médecine Gériatrique, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Bonnefoy
authors.affiliation: Service de Maladies Infectieuses, Centre Hospitalier de la Croix-Rousse, Hospices Civils de Lyon, France.
authors.forename: Tristan
authors.initials: T
authors.lastname: Ferry
mesh_terms: D059787:Acute Pain / Q000209:etiology*; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005157:Facial Pain / Q000209:etiology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008198:Lymph Nodes / Q000382:microbiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D009302:Nasopharyngeal Diseases / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18