Laryngeal actinomycosis accompanying laryngeal carcinoma: report of two cases

Abstract

Actinomycosis is a systemic chronic bacterial infection caused by Actinomyces israelii, an anaerobic organism normally resident in the human mouth. It can involve any organ, but cervicofacial disease is the most common. Laryngeal involvement is rare and usually occurs secondary to the oral, cervical or mandibular disease. There are only a few cases of primary laryngeal actinomycosis (LA) in the literature. Actinomycosis can also be a complication of head and neck surgery. Here we present two cases of LA accompanying laryngeal carcinoma and discuss in the literature about this event.

Laryngeal actinomycosis mimicking relapse of laryngeal carcinoma in a 67-year-old man: Figure 1

“…Laryngeal actinomycosis is poorly described, as ∼20 cases are reported in the literature only 2 3. It is noteworthy that most of patients, as in our case: (1) had a history of laryngeal carcinoma and radiotherapy and (2) presented with an ulceration mimicking laryngeal cancer relapse, neither with abscess nor sinus tract 2 3. Pathological analysis is of crucial importance for the diagnosis, as the bacterial cultures could be negative 1.…”

“…Typically, actinomycosis is associated with large slow-progressive multiple abscess formations with draining sinus tracts 1. Laryngeal actinomycosis is poorly described, as ∼20 cases are reported in the literature only 2 3. It is noteworthy that most of patients, as in our case: (1) had a history of laryngeal carcinoma and radiotherapy and (2) presented with an ulceration mimicking laryngeal cancer relapse, neither with abscess nor sinus tract 2 3.…”

Vocal Cord Actinomycosis Mimicking a Laryngeal Tumor

“…A review of the literature reveals that actinomycosis of the larynx is often associated with an underlying history of squamous cell carcinoma of the larynx and therapeutic radiation therapy [5]. An underlying history of systemic lupus erythematosus (SLE) and immunosuppression after renal transplantation has also been reported [6].…”

Laryngeal Actinomycosis: A Case Report and Systematic Review of 32 Cases in the Literature

“…Patients should be followed in clinic to insure a carcinoma is not present in addition to the actinomycosis. Ongoing symptomology following adequate antibiotic therapy for actinomycosis should warrant prompt swift laryngoscopic evaluation and biopsy for suspected laryngeal carcinoma as 10% of patients with laryngeal actinomycosis have been found to have a current malignancy in our review of the literature [17,23].…”