Laryngeal tuberculosis misdiagnosed as laryngeal carcinoma – a case report

Purpose: Laryngeal tuberculosis is a form of extrapulmonary tuberculosis that occurs in only 1% of all tuberculosis cases. It can be accompanied by pulmonary tuberculosis, or the larynx can be the only organ affected. Clinical, laryngoscopic and radiological findings of laryngeal tuberculosis tend to mimic laryngeal cancer, delaying the appropriate treatment. In this paper, we present a case of the laryngeal and pulmonary tuberculosis which was primarily diagnosed and almost treated as laryngeal carcinoma.
Case Description: An 84 years old Caucasian male presented with a 3-months history of hoarseness, odynophagia, dysphagia, cough with expectoration and weight loss. After the biopsy of the laryngeal ulceration, a squamous cell carcinoma was suspected. However, chest X-ray and CT scan detected pulmonary infiltrates, while the positive sputum smear for acid-fast bacilli was obtained and the sputum cultures grew Mycobacterium tuberculosis. Detailed histopathological analysis of the biopsies was in accordance with tuberculosis. After the finishing of antituberculous treatment, the patient reported no symptoms of the diseases, laryngoscopic findings showed no signs of neoplastic tissue, and CT findings showed partial radiological regression. Discussion and Conclusions: Distinguishing laryngeal carcinoma and tuberculosis can be very challenging, even after obtaining histopathological material. Nevertheless, biopsies should be taken from all suspicious lesions and at multiple sites and Ziehl-Neelson staining of sputum and bioptic tissue is inevitable. Otorhinolaryngologists should always consider tuberculosis when evaluating laryngeal lesions, especially nowadays when the incidence of laryngeal tuberculosis is increasing in developing countries.