Nasopharngeal Tuberculosis Simulating Cancer: About 2 Cases

Abstract

Primitive tuberculosis of the nasopharynx is rare. Clinical symptoms and paraclinical examinations are often confusing. Pseudotumour forms are frequent, which poses a problem of differential diagnosis with cavum cancer. We reported two cases of nasopharyngeal tuberculosis, followed up in the ear, nose and throat department of the Arrazi Hospital of the Mohammed VI University Hospital in Marrakesh. The first case concerned a 22-year-old female patient admitted to hospital for an etiological assessment of a right spinal adenopathy evolving in a context of altered general condition with weight loss, anorexia, and night sweats. The second case was a 14-year-old patient with a fistulised right spinal adenopathy with nasal obstruction and homolateral deafness. Nasofibroscopy in both patients showed a burgeoning tumour on the right posterolateral wall. A biopsy of the cavum was indicated. The histological study of the biopsies revealed an epithelial-giganto-cellular granuloma with caseous necrosis. This allowed to make the diagnosis of nasopharyngeal tuberculosis, and an antibacillary treatment was instituted. The evolution was favorable.

Extraganglionary Localization of Tuberculosis in Otorhinolaryngology: Rare Presentations About 29 Cases

“…However, certain local factors (trauma, chronic atrophic rhinitis) or general factors (poor hygiene, immunosuppression) could facilitate the infection by BK 1 . Endoscopy finds the aspect of a granuloma or a superficial mucosal ulceration most often located in the anterior part of the nasal septum or in the inferior turbinate and rarely on the floor of the nasal cavity [14][15][16] . The lesion is often unilateral but bilateral lesions may occur in 30% of cases 11 .…”

“…They are sometimes a revelation mode of the disease showing the lymphatic richness of the cavum. Rhinocavoscopy can show different macroscopic aspects; these may include one or more ulcerations, regular mucosal enlargement, a polyploid tumor or irregular swelling 16,17 . Biopsies allow anatomopathological and bacteriological confirmation and rule out cavum cancer.…”