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It is not always a malignancy!
Introduction Head and neck cancer is a common cause for sore throat and dysphagia in heavy smokers and drinkers. However, rare but typical entities should not be excluded from differential diagnosis in those cases.
Case Report A 41-years old worker of a circus with dysphagia underwent panendoscopy in an ENT-department in the north of Germany. An ulcerous lesion of the left false chord was seen and several biopsies were taken. These revealed only an unspecific, ulcerous-phlegmonous inflammation without hints of malignancy. The recommended reexploration and imaging could not be performed as the circus travelled to the south. At our department we could confirm the diagnosis and establish suspicious cervical lymph nodes. Due to the existing data we planned an imaging prior reendoscopy. In the CT-scan the findings were highly suspicious for a tuberculosis which could be confirmed by microscopy and culture whereas the quantiferon test was negative. A chemotherapy was begun according to the guidelines.
Conclusions This case demonstrates the importance of the tuberculosis especially in risk groups. The otorhinolaryngologist should deal with this issue in regard of disease control and be able to arrange the adequate diagnostical examination.
10 June 2020 (online)
© Georg Thieme Verlag KG
Stuttgart · New York