One world but miles apart: great mimicry of nasopharyngeal tuberculosis with nasopharyngeal carcinoma

Author:

Wong Bao Ling1ORCID,Mohamad Irfan2ORCID,Marimuthu Shashi Gopalan3ORCID,Abu Bakar Muhammad Nasri3ORCID

Affiliation:

1. Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Sains Malaysia, Malaysia; Department of Otorhinolaryngology, Head and Neck Surgery, Sibu Hospital, Malaysia

2. Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Sains Malaysia, Malaysia

3. Department of Otorhinolaryngology, Head and Neck Surgery, Sibu Hospital, Malaysia

Abstract

Nasopharyngeal tuberculosis is rare, even in endemic areas. It can be primary or secondary to pulmonary or systemic tuberculosis. Although nasopharyngeal tuberculosis represents less than 1% of all tuberculosis cases, there has been an increase in cases reported recently. The variety of presenting symptoms in nasopharyngeal tuberculosis makes it challenging to diagnose because the condition commonly mimics other pathologies. In this paper, we would like to share our experience managing three cases of rare primary nasopharyngeal tuberculosis with different backgrounds. We provide a comparison in their clinical presentations, and endoscopic and radiological features, highlighting the situations when nasopharyngeal tuberculosis needs to be considered as a differential diagnosis. A nasopharyngeal biopsy is helpful to establish the diagnosis. The patients responded well to anti-tuberculosis chemotherapy. The variation in findings proves that it is important to have a high index of suspicion in order to get an accurate early diagnosis and initiate proper treatment.

Publisher

Medical Communications Sp. z.o.o.

Subject

Family Practice,Pediatrics, Perinatology and Child Health

Reference13 articles.

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2. Rohwedder JJ: Upper respiratory tract tuberculosis. Sixteen cases in a general hospital. Ann Intern Med 1974; 80: 708–713.

3. Mohamad I, Nik Hassan NFH, Nik Othman NA: Head and neck tuberculosis: the great mimic. Malays Fam Physician 2016; 11: 38.

4. Ministry of Health Malaysia, Academy of Medicine Malaysia, Malaysian Thoracic Society, World Health Organization: Clinical Practice Guidelines – Management of Tuberculosis (3rd Edition). Malaysia Health Technology Assessment Section (MaHTAS) 2012; 5: 4–7.

5. Azizah Ab M, Nor Saleha IT, Noor Hashimah A et al.: Summary of Malaysian National Cancer Registry Report 2007–2011. National Cancer Institute, Ministry of Health 2015; 1: 44–45.

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