Nasopharyngeal tuberculosis and carcinoma: A rare concurrence

Ninan S, Idris R, Chong VH, Telisinghe PU.

Brit J Med Health Sci. 2013. 1;14-21.

ABSTRACT

Nasopharyngeal carcinoma (NPC) remains endemic in the East and an important cause of morbidity and mortality. In our region where the prevalence of NPC is high, malignancy should be ruled out in cases presenting with serous otitis media due to nasopharyngeal mass. Importantly, infectious disease like tuberculosis (TB) is also frequently seen in this region and manifestations can be varied and mimic many neoplasm. In regions where both conditions are still common, concomitant pathology can occur and can cause diagnostic dilemma if not suspected. This can lead to poor outcome. We present a rare case of synchronous primary nasopharyngeal TB and NPC in a 50-year-old male who presented with chronic otitis media. Initial evaluations diagnosed the nasopharyngeal TB but missed the NPC. The NPC was diagnosed four months later when the patient presented with an episode of severe epistaxis while on anti-tuberculous treatment. Our case highlights the importance of considering synchronous pathologies especially in cases where symptoms persist in spite of treatment. To the best of our knowledge, no such presentation has been previously reported in the world literature.

Correspondence: Ninan S. Department of Ororhinolaryngology, RIPAS Hospital, Bandar Seri Begawan BA 1710, Brunei Darussalam.

Article freely available for journal website at http://www.bjmhs.baar.org.uk/uploads/june issue/BJMHS-1148-13-NASOPHARYNGEAL_TUBERCULOSIS_AND_CARCINOMA.pdf