rifampin and Pharyngeal-Neoplasms

Topics: Adenoids; Adult; Antitubercular Agents; Diagnosis, Differential; Ethambutol; Female; Humans; Isoniazid; Mycobacterium tuberculosis; Pharyngeal Neoplasms; Pyrazinamide; Rifampin; Treatment Outcome; Tuberculosis

Tuberculosis of the pharynx is less common than tuberculosis of the larynx. We present a rare case of tuberculosis of the pyriform fossa which clinically masqueraded as a malignancy. Our patient showed a prompt improvement in symptoms after commencing antitubercular treatment.

Topics: Adult; Antitubercular Agents; Diagnosis, Differential; Drug Therapy, Combination; Ethambutol; Humans; Isoniazid; Laryngoscopy; Male; Pharyngeal Diseases; Pharyngeal Neoplasms; Pyrazinamide; Radiography; Rifampin; Tuberculosis; Tuberculosis, Laryngeal; Tuberculosis, Pulmonary

A 44-year-old man, a heavy smoker over many years, complained of hoarseness for 8 weeks with weight loss and dysphagia. Malignant tumour of the pharynx was suspected. Examination revealed a swelling of the right upper lip, tumorous changes in the right buccal mucosa, about 6 x 6 cm in size, as well as enlargement of the cervical lymph-nodes. Microlaryngoscopy revealed a three-level tumour of the entire side of the right larynx. Histological examination of biopsies of the right false and true vocal cords as well as the buccal mucosa demonstrated numerous, partly caseous epithelioid granulomas with Langhans giant cells. Ziehl-Neelsen staining showed acid-fast rods. Combined tuberculostatic treatment with isoniazid, rifampicin, ethambutol and pyrazinamide achieved regression of all signs and symptoms within two months. This case emphasizes the need for including laryngeal tuberculosis in the differential diagnosis of seemingly malignant laryngeal tumours.

Topics: Adult; Diagnosis, Differential; Drug Therapy, Combination; Endoscopy; Ethambutol; Humans; Isoniazid; Male; Pharyngeal Diseases; Pharyngeal Neoplasms; Pyrazinamide; Rifampin; Tuberculosis; Tuberculosis, Laryngeal; Tuberculosis, Oral